Individual
MR. CARROLL EUGENE WALLS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1600 RIVERFRONT DRIVE, LITTLE ROCK, AR 72202-3121
(501) 663-6965
(501) 603-0675
Mailing address
10712 YOSEMITE VALLEY DR, LITTLE ROCK, AR 72212-3659
(501) 681-4448
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR592
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134290721
—
AR
Enumeration date
10/10/2008
Last updated
10/19/2010
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