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General NPI Number Information
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NPI Number | 1609209147
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Entity Type | Individual
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Provider Name | PAUL W CREEL OTR/L CHT
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Gender | Male
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Dates
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Enumeration Date | 08/20/2013
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Last Update Date | 08/20/2013
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Provider Practice Location Address
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Address Line | 4301 W MARKHAM ST # 547-11
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7101
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Country | US
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Telephone | 501-686-6102
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Fax | 501-296-1216
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Provider Business Mailing Address
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Address Line | 4301 W MARKHAM ST # 547-11
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City | LITTLE ROCK
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State | AR
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Zip | 72205-7101
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Country | US
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Telephone | 501-686-6102
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Fax | 501-296-1216
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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 | 225XH1200X
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Taxonomy Name | Hand Occupational Therapist
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License Number | OTR 371
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License Number State | AR
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