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General NPI Number Information
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NPI Number | 1356660856
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Entity Type | Organization
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Legal Business Name | FOX-TROT THERAPY SERVICES, INC
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Dates
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Enumeration Date | 05/24/2010
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Last Update Date | 05/24/2010
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Provider Practice Location Address
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Address Line | 2316 SHEFFIELD DR
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City | JONESBORO
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State | AR
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Zip | 72401-8134
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Country | US
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Telephone | 870-329-7344
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Fax | 870-268-1199
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Provider Business Mailing Address
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Address Line | 2316 SHEFFIELD DR
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City | JONESBORO
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State | AR
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Zip | 72401-8134
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Country | US
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Telephone | 870-329-7344
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Fax | 870-268-1199
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Authorized Official
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Title or Position | SLP, OWNER
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Name | KIMBERLY FOX
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Credential | MED, CCC-SLP
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Telephone | 870-329-7344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP#2969
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License Number State | AR
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