Provider Demographics
NPI:1518396779
Name:JENKINS, LAROYA (DPT)
Entity Type:Individual
Prefix:
First Name:LAROYA
Middle Name:
Last Name:JENKINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LAROYA
Other - Middle Name:
Other - Last Name:DOSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:4409 E 46TH ST APT 18
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-1967
Mailing Address - Country:US
Mailing Address - Phone:501-249-0295
Mailing Address - Fax:
Practice Address - Street 1:4500 S LANCASTER RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7167
Practice Address - Country:US
Practice Address - Phone:214-857-1437
Practice Address - Fax:214-857-1281
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 3541225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist