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Organization

MOTILITY MLK, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREG JOHNSON CPO (CERTIFIED PROSTHETIST ORTHOTIST)
(479) 305-9374
Entity
Organization

Contact information

Practice address
120 HILL ST, HOT SPRINGS, AR 71901-6238
(501) 620-4800
(848) 272-8975
Mailing address
PO BOX 1966, HOT SPRINGS, AR 71902-1966
(501) 620-4800
(848) 272-8975

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
335E00000X
Prosthetic/Orthotic Supplier
CP2198
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1710363486
MO
05
201241430A
KS
05
213521716
AR
05
Q036977
TN
Enumeration date
08/05/2015
Last updated
03/26/2026
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