Healthcare Provider Details

I. General information

NPI: 1285887018
Provider Name (Legal Business Name): LARRY FRANK HENSLEE JR. CT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 10/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 W 7TH ST
LITTLE ROCK AR
72205-5446
US

IV. Provider business mailing address

4300 W 7TH ST
LITTLE ROCK AR
72205-5446
US

V. Phone/Fax

Practice location:
  • Phone: 501-257-6484
  • Fax:
Mailing address:
  • Phone: 501-257-6484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QC2700X
TaxonomyCytotechnology Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: