Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist |
NPI | 1164196119 |
---|---|
Provider Name | Angela M Frierson |
First Address | North Little Rock, AR 72117-0025 |
Second Address | North Little Rock, AR 72117-9779 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2021 |
Last Update Date | 03/08/2021 |