Individual
MS. ELLA BETH DURHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO, C.PED
Contact information
Practice address
2930 E MOORE AVE, SEARCY, AR 72143-4831
(501) 368-0868
(501) 368-0003
Mailing address
2930 E MOORE AVE, SEARCY, AR 72143-4831
(501) 368-0868
(501) 368-0003
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
—
—
224P00000X
Prosthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
457554716
—
AR
Enumeration date
12/11/2006
Last updated
02/18/2015
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