De Luca, Kenny A

De Luca, Kenny A is an sole proprietor health care provider with primary practice located at 9843 Maumelle Blvd , North Little Rock AR 72113-7027. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. De Luca, Kenny A can be contacted via phone (501) 753-2201.

Contact Information

Primary practice address
9843 Maumelle Blvd North Little Rock AR 72113-7027
Phone: (501) 753-2201
Fax: (501) 753-2207
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT2475 Arkansas

Profile Details

NPI number 1114901451
LBN Legal business name De Luca, Kenny A
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 30th, 2005
Last updated May 10th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114901451 NPPES
Arkansas Other 5F332 AR BCBS GROUP
Arkansas Other 5W795 AR BCBS GROUP

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