Organization
KIDS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANTOINETTE BEAUGARD (OWNER)
(501) 612-4406
Entity
Organization
Contact information
Practice address
4124 W 11TH ST, LITTLE ROCK, AR 72204-2008
(501) 612-4406
Mailing address
4124 W 11TH ST, LITTLE ROCK, AR 72204-2008
(501) 612-4406
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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