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General NPI Number Information
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NPI Number | 1083909295
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Entity Type | Organization
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Legal Business Name | COMPLETE PEDIATRICS
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 6917 GEYER SPRINGS RD SUITE 1-S
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City | LITTLE ROCK
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State | AR
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Zip | 72209-2727
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Country | US
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Telephone | 501-570-4004
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Fax |
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Provider Business Mailing Address
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Address Line | 6917 GEYER SPRINGS RD SUITE 1-S
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City | LITTLE ROCK
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State | AR
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Zip | 72209-2727
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Country | US
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Telephone | 501-570-4004
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS LAURA JENNINGS
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Credential |
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Telephone | 501-837-7216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 2013
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 1949
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2385
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License Number State | AR
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