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General NPI Number Information
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NPI Number | 1285746529
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Entity Type | Organization
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Legal Business Name | LITTLE ROCK FOOT CLINIC, PA
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 01/02/2014
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Provider Practice Location Address
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Address Line | 424 N UNIVERSITY AVE
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3109
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Country | US
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Telephone | 501-664-8888
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Fax | 501-664-3106
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Provider Business Mailing Address
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Address Line | 424 N UNIVERSITY AVE
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City | LITTLE ROCK
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State | AR
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Zip | 72205-3109
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Country | US
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Telephone | 501-664-8888
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Fax | 501-664-3106
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Authorized Official
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Title or Position | OWNER
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Name | TERRI R COHEN
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Credential | DPM
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Telephone | 501-664-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State | AR
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