Provider Demographics
NPI:1477563138
Name:LITTLE HANDS LITTLE FEET, LLC
Entity Type:Organization
Organization Name:LITTLE HANDS LITTLE FEET, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAIGE
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCOPER
Authorized Official - Suffix:
Authorized Official - Credentials:PT, PCS
Authorized Official - Phone:850-862-7227
Mailing Address - Street 1:3924 MESA RD
Mailing Address - Street 2:
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-2061
Mailing Address - Country:US
Mailing Address - Phone:850-862-7227
Mailing Address - Fax:850-862-2421
Practice Address - Street 1:4 JACKSON ST NE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-4925
Practice Address - Country:US
Practice Address - Phone:850-862-7227
Practice Address - Fax:850-862-2421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT17648261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY036GOtherBLUE CROSS BLUE SHIELD