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ALLOPLASTIC RECONSTRUCTION

Eye and Vision Services Providers Technician/Technologist Ocularist

Provider NPI: 1598049744

Organization Information:
Organization Name:  ALLOPLASTIC RECONSTRUCTION
Organization is not Subpart
Authorized Official:  MICHAEL  KACZKOWSKI  PRESIDENT  501-265-0100

Practice Location:
3924 W MARKHAM ST  LITTLE ROCK, AR 72205-5528 US
Tel: 501-265-0100  Fax: 501-265-0102

Business Mailing Address:
3924 W MARKHAM ST  LITTLE ROCK, AR 72205-5528 US
Tel: 501-265-0100  Fax: 501-265-0102

NPI Information:
NPI: 1598049744
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y156FX1700XEye and Vision Services Providers
Technician/Technologist
Ocularist
N174400000XOther Service Providers
Specialist
N229N00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Anaplastologist
N332BC3200XSuppliers
Durable Medical Equipment & Medical Supplies
N335E00000XSuppliers
Prosthetic/Orthotic Supplier
AROPP00038

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 156FX1700X

Type:

Classification:



Definition:



MEDICAL JOBS AR - Page 1

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