Individual
ETHAN ROYCE DICKESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
824 N TYLER ST, LITTLE ROCK, AR 72205-3535
(501) 664-2691
Mailing address
425 MILDRED ST, CONWAY, AR 72034-6178
(501) 206-4113
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251P0200X
Pediatric Physical Therapist
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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