Petty Medical Clinic, Llc

NPI 1255746772 - Clinic/Center - 261QP2300X

NPI Details
NPI 1255746772
Enumeration Date 06/23/2014
Last Updated 06/23/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name CORWIN CORWIN
Position PHYSICIAN / OWNER
Phone (479) 254-1005
Fax (479) 668-4003
Practice Location
114 HARRISON AVE
SUITE C
LOWELL AR, 72745-9047, US
Phone (479) 254-1005
Fax (479) 668-4003
Business Location
114 HARRISON AVE
SUITE C
LOWELL AR, 72745-9047, US
Phone (479) 254-1005
Fax (479) 668-4003
Toxanomy
Taxonomy Code 261QP2300X
License State Arkansas
License Number E2717
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According to our database, Petty Medical Clinic, Llc NPI is 1255746772, taxonomy code is 261QP2300X and license number is E2717, license state is located at Arkansas. Petty Medical Clinic, Llc physically located at 114 Harrison Ave, Lowell AR, 72745-9047. NPI Number 1033115704 has the healthcare provider type.

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1255746772 NPI number is provided on an as is basis without warranty of any kind. 1255746772 is maintained by the National Plan & Provider Enumeration System. The contents of Petty Medical Clinic, Llc are for informational purposes only.