Individual
MR. ALBERT HENRY CICCEL JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LO,C-PED,BOCOF
Contact information
Practice address
2200 FORT ROOTS DR BLDG 89, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-1610
(501) 257-1624
Mailing address
7603 JACKSONVILLE CUTOFF RD APT B, JACKSONVILLE, AR 72076-3956
(501) 257-1610
(501) 257-1624
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
OPP00030
AR
225000000X
Orthotic Fitter
C17466
—
Other
Enumeration date
10/14/2008
Last updated
10/14/2008
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