MEDICARE: MR. GREGORY W ARMSTRONG CPO/L

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	224L00000X	Pedorthist	OPP00268	AR
2	224P00000X	Prosthetist	OPP00268	AR
3	222Z00000X	Orthotist	OPP00268	AR

General Provider Information

NPI Number	:	1568642072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREGORY W ARMSTRONG CPO/L

Provider Business Mailing Address
First Line	:	1 CHILDREN'S WAY, SLOT 104
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202
Country	:	US
Telephone Number	:	501-364-2262
Fax Number	:	501-364-3564

Provider Business Practice Location Address
First Line	:	1 CHILDREN'S WAY, SLOT 104
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72202
Country	:	US
Telephone Number	:	501-364-2262
Fax Number	:	501-364-3564

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2007
Last Update Date	:	04/11/2018

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