Healthcare Provider Details

I. General information

NPI: 1356597124
Provider Name (Legal Business Name): GINGER KATHERINE CHEEK LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GINGER KATHERINE GIDDENS LAC

II. Dates (important events)

Enumeration Date: 08/13/2008
Last Update Date: 05/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5905 FOREST PL SUITE 100
LITTLE ROCK AR
72207-5244
US

IV. Provider business mailing address

PO BOX 7255
LITTLE ROCK AR
72217-7255
US

V. Phone/Fax

Practice location:
  • Phone: 501-666-4949
  • Fax: 501-660-6840
Mailing address:
  • Phone: 870-918-8767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA0807043
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: