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General NPI Number Information
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NPI Number | 1710137500
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Entity Type | Organization
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Legal Business Name | PRO-KIDS THERAPY, LLC
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 10/28/2008
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Provider Practice Location Address
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Address Line | 10515 W MARKHAM ST SUITE I-3
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2139
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Country | US
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Telephone | 501-823-0578
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Fax | 501-823-0579
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Provider Business Mailing Address
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Address Line | 10515 W MARKHAM ST SUITE I-3
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City | LITTLE ROCK
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State | AR
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Zip | 72205-2139
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Country | US
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Telephone | 501-823-0578
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Fax | 501-823-0579
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Authorized Official
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Title or Position | OWNER
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Name | MR. CURTIS EDWIN CHATHAM
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Credential | MCD, CCC-SLP
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Telephone | 501-823-0578
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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 | SP1750
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License Number State | AR
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