Individual
FRANK CORDOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 S PARKER HASKELL ST, BENTON, AR 72015-8961
(501) 615-7959
Mailing address
900 S PARKER HASKELL ST, BENTON, AR 72015-8961
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12022
—
AR
05
—
35361
—
GA
05
—
ADECR
—
AR
Enumeration date
03/22/2022
Last updated
03/22/2022
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