Organization
CRESTWOOD FOOT CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTHA A. JACKSON DPM (OWNER)
(501) 771-4785
Entity
Organization
Contact information
Practice address
2501 CRESTWOOD RD, SUITE 101, NORTH LITTLE ROCK, AR 72116-6864
(501) 771-4785
(501) 771-4785
Mailing address
2501 CRESTWOOD RD, SUITE 101, NORTH LITTLE ROCK, AR 72116-6864
(501) 771-4785
(501) 771-4787
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
87
AR
Other
Enumeration date
04/29/2008
Last updated
07/14/2020
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