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General NPI Number Information
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NPI Number | 1972929230
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Entity Type | Organization
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Legal Business Name | NINE TWO SIX, INC
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Dates
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Enumeration Date | 03/11/2014
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Last Update Date | 03/11/2014
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Provider Practice Location Address
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Address Line | 2577 N LOWELL RD
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City | SPRINGDALE
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State | AR
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Zip | 72764-1818
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Country | US
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Telephone | 479-856-2626
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Fax |
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Provider Business Mailing Address
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Address Line | 1755 KISSINGER AVE
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City | SPRINGDALE
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State | AR
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Zip | 72762-9063
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Country | US
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Telephone | 479-856-2626
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ERIN OLIVER
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Credential | CCC-SLP
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Telephone | 479-856-2626
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | SLP 2268
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License Number State | AR
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