Healthcare Provider Details

I. General information

NPI: 1467691360
Provider Name (Legal Business Name): LINZI NICOLE SOULES DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2009
Last Update Date: 02/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6900 N HILLS BLVD
NORTH LITTLE ROCK AR
72116-5423
US

IV. Provider business mailing address

6900 N HILLS BLVD
NORTH LITTLE ROCK AR
72116-5423
US

V. Phone/Fax

Practice location:
  • Phone: 501-835-9607
  • Fax: 501-833-0957
Mailing address:
  • Phone: 501-835-9607
  • Fax: 501-833-0957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number2919
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: