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General NPI Number Information
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NPI Number | 1669324786
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Entity Type | Organization
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Legal Business Name | TOPS SHOES
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 19718 INTERSTATE 30 N
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City | BENTON
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State | AR
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Zip | 72019-8023
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Country | US
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Telephone | 501-794-1501
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Fax |
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Provider Business Mailing Address
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Address Line | 19718 INTERSTATE 30 N
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City | BENTON
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State | AR
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Zip | 72019-8023
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Country | US
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Telephone | 501-794-1501
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Fax |
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Authorized Official
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Title or Position | CERTIFIED PEDORTHIST
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Name | BART DICKINSON
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Credential | C.PED
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Telephone | 501-860-5708
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224L00000X
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Taxonomy Name | Pedorthist
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License Number |
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License Number State |
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