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Individual

MR. RANDAL LEE SCOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.T.R.

Contact information

Practice address
500 TIGER BLVD., BENTONVILLE, AR 72712-2011
(479) 254-5065
Mailing address
6508 HEARTH FALLS DR., ROGERS, AR 72758
(479) 422-7442

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTR-1569
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
146648721
AR
Enumeration date
04/19/2007
Last updated
07/07/2009
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