Provider Demographics
NPI:1659518306
Name:SAVAGE, DAVID (CO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SAVAGE
Suffix:
Gender:M
Credentials:CO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2890A W WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-0335
Mailing Address - Country:US
Mailing Address - Phone:479-631-9100
Mailing Address - Fax:479-631-9698
Practice Address - Street 1:2890A W WALNUT ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-0335
Practice Address - Country:US
Practice Address - Phone:479-631-9100
Practice Address - Fax:479-631-9698
Is Sole Proprietor?:No
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROPP00139222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist