Provider Demographics
NPI:1578897088
Name:KILLGORE, MARGARET C (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARGARET
Middle Name:C
Last Name:KILLGORE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MISS
Other - First Name:MARGARET
Other - Middle Name:L
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:210 MANOR STREET
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:AR
Mailing Address - Zip Code:72364
Mailing Address - Country:US
Mailing Address - Phone:870-739-1600
Mailing Address - Fax:870-739-1605
Practice Address - Street 1:620 THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:WEST MEMPHIS
Practice Address - State:AR
Practice Address - Zip Code:72301-3257
Practice Address - Country:US
Practice Address - Phone:870-702-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-30
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics