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General NPI Number Information
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NPI Number | 1255485827
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Entity Type | Organization
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Legal Business Name | ASCENT AQUISITION CORP- PSC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 2410 PINE ST
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City | ARKADELPHIA
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State | AR
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Zip | 71923-4335
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Country | US
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Telephone | 870-245-2210
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Fax |
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Provider Business Mailing Address
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Address Line | 399 WYLDEWOOD DR
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City | GURDON
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State | AR
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Zip | 71743-9089
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Country | US
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Telephone | 870-353-6778
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Fax |
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Authorized Official
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Title or Position | COTA
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Name | LINDA LEAMONS
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Credential |
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Telephone | 870-245-2210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA-334
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License Number State | AR
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