Willis Clinic, Pllc

NPI 1063619567 - Clinic/Center - 261QP2300X

NPI Details
NPI 1063619567
Enumeration Date 06/28/2007
Last Updated 03/19/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name SHERITA DEVONE SHERITA
Position OWNER
Phone (870) 563-2545
Fax (870) 563-2482
Practice Location
608 W UNION AVE
OSCEOLA AR, 72370-3014, US
Phone (870) 563-2545
Fax (870) 563-2482
Business Location
608 W UNION AVE
OSCEOLA AR, 72370-3014, US
Phone (870) 563-2545
Fax (870) 563-2482
Toxanomy
Taxonomy Code 261QP2300X
License State Arkansas
License Number E5031
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According to our database, Willis Clinic, Pllc NPI is 1063619567, taxonomy code is 261QP2300X and license number is E5031, license state is located at Arkansas. Willis Clinic, Pllc physically located at 608 W Union Ave, Osceola AR, 72370-3014. NPI Number 1033115704 has the healthcare provider type.

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1063619567 NPI number is provided on an as is basis without warranty of any kind. 1063619567 is maintained by the National Plan & Provider Enumeration System. The contents of Willis Clinic, Pllc are for informational purposes only.