Healthcare Provider Details

I. General information

NPI: 1477563138
Provider Name (Legal Business Name): LITTLE HANDS LITTLE FEET, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 JACKSON ST NE
FORT WALTON BEACH FL
32548-4925
US

IV. Provider business mailing address

3924 MESA RD
DESTIN FL
32541-2061
US

V. Phone/Fax

Practice location:
  • Phone: 850-862-7227
  • Fax: 850-862-2421
Mailing address:
  • Phone: 850-862-7227
  • Fax: 850-862-2421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberPT17648
License Number StateFL

VIII. Authorized Official

Name: MRS. PAIGE L. SCOPER
Title or Position: OWNER/DIRECTOR
Credential: PT, PCS
Phone: 850-862-7227