Individual
MR. MARK A DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CTRS
Contact information
Practice address
2200 FORT ROOTS DR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-3285
Mailing address
1500 S TAYLOR ST, LITTLE ROCK, AR 72204-2663
(501) 257-3285
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
26219
AR
Other
Enumeration date
08/24/2006
Last updated
07/08/2007
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