Organization
DTR MEDICAL, INC
Active
Other names
Women's Pavilion
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF S LITTLE (PRESIDENT/OWNER)
(479) 936-7050
Entity
Organization
Contact information
Practice address
122 S 1ST ST, ROGERS, AR 72756-4502
(479) 936-7050
(479) 936-7080
Mailing address
122 S 1ST ST, ROGERS, AR 72756-4502
(479) 936-7050
(479) 936-7080
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154549716
—
AR
Enumeration date
06/21/2005
Last updated
05/10/2023
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