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General NPI Number Information
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NPI Number | 1205716479
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Entity Type | Organization
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Legal Business Name | THERAMOBIL ORTHOTICS AND PROSTHETICS, PLLC
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Dates
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Enumeration Date | 09/06/2025
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Last Update Date | 11/15/2025
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Provider Practice Location Address
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Address Line | 1912 GREEN MOUNTAIN DR APT 130
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City | LITTLE ROCK
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State | AR
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Zip | 72212-4019
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Country | US
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Telephone | 479-252-1252
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Fax |
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Provider Business Mailing Address
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Address Line | 1912 GREEN MOUNTAIN DR APT 130
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City | LITTLE ROCK
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State | AR
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Zip | 72212-4019
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Country | US
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Telephone | 479-252-1252
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA FERGUSON
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Credential | PT
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Telephone | 479-252-1252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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