Individual
VELVET V MEDLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
5905 REMINGTON CIR, FORT SMITH, AR 72903-6523
(479) 452-7773
(479) 452-7774
Mailing address
PO BOX 11122, FORT SMITH, AR 72917-1122
(479) 452-7773
(479) 452-7774
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
4397
OK
225100000X
Physical Therapist
Primary
PT1835
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136730742
—
AR
Enumeration date
04/07/2006
Last updated
09/06/2013
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