MEDICARE: ENCORE HEALTH, P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1508108416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENCORE HEALTH, P.A.

Provider Business Mailing Address
First Line	:	4617 E MCCAIN BLVD
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2904
Country	:	US
Telephone Number	:	501-945-0680
Fax Number	:

Provider Business Practice Location Address
First Line	:	4617 E MCCAIN BLVD
Second Line	:
City	:	NORTH LITTLE ROCK
State	:	AR
Zip	:	72117-2904
Country	:	US
Telephone Number	:	501-945-0680
Fax Number	:

Authorized Official
Title or Position	:	CLINIC DIRECTOR
Name	:	MR. ANDY DAVIS
Credential	:
Telephone Number	:	501-945-0680

Provider Enumeration Date	:	03/19/2013
Last Update Date	:	03/19/2013

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Directions to “ENCORE HEALTH, P.A. ” Practice Location

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