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General NPI Number Information
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NPI Number | 1295773919
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Entity Type | Individual
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Provider Name | BETH STAMP PT, DPT, PCS
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Gender | Female
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 03/06/2013
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Provider Practice Location Address
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Address Line | 1500 WILSON LOOP
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City | WARD
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State | AR
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Zip | 72176-8656
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Country | US
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Telephone | 501-941-5630
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Fax | 501-843-2270
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Provider Business Mailing Address
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Address Line | 420 CHIMNEY ROCK DR
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72120-5846
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Country | US
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Telephone | 501-912-6403
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Fax | 501-843-2270
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | PT1056
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License Number State | AR
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