Organization
KIDSPOT JACKSON COUNTY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY TUCKER (CO-OWNER)
(870) 974-9114
Entity
Organization
Contact information
Practice address
6309 HIGHWAY 367 N, TUCKERMAN, AR 72473-9389
(870) 974-9114
Mailing address
6309 HIGHWAY 367 N, TUCKERMAN, AR 72473-9389
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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