IndividualActive
Angela Gray, PTA
NPI 1477510105 · Physical Therapy Assistant · Benton, AR
Provider details
- NPI number
- 1477510105
- Entity type
- Individual
- Primary specialty
- Physical Therapy AssistantRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Female
- Sole proprietor
- Yes
- License
- PTA1804 (AR)
Mailing address
17706 Interstate 30 N
Benton, AR 72019-2907
Registry dates
- Enumerated
- 2006-04-27
- Last updated
- 2022-07-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.