Provider Demographics
NPI:1972616696
Name:DUVALL, MARY LYNN (MS,PT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:LYNN
Last Name:DUVALL
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
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Mailing Address - Street 1:2310 AVENUE 7 NE
Mailing Address - Street 2:
Mailing Address - City:ATKINS
Mailing Address - State:AR
Mailing Address - Zip Code:72823-3115
Mailing Address - Country:US
Mailing Address - Phone:479-641-7059
Mailing Address - Fax:
Practice Address - Street 1:2200 FORT ROOTS DR #117/NLR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114
Practice Address - Country:US
Practice Address - Phone:501-257-3031
Practice Address - Fax:501-257-2993
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR1931225100000X, 2251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology