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General NPI Number Information
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NPI Number | 1801872304
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Entity Type | Organization
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Legal Business Name | ARKANSAS CENTER FOR PHYSICAL MEDICINE & REHABILITATION
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Dates
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Enumeration Date | 12/16/2005
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 636 W BROADWAY ST
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-5526
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Country | US
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Telephone | 501-374-1153
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Fax | 501-374-6213
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Provider Business Mailing Address
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Address Line | 636 W BROADWAY ST
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72114-5526
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Country | US
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Telephone | 501-374-1153
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Fax | 501-374-6213
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BRANDLYN MICHELLE FRENSLEY
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Credential |
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Telephone | 501-374-1153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 992
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License Number State | AR
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