Healthcare Provider Details

I. General information

NPI: 1639535305
Provider Name (Legal Business Name): AMY WOLF L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY BABB

II. Dates (important events)

Enumeration Date: 01/11/2016
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 FORT ST STE J
BARLING AR
72923-2045
US

IV. Provider business mailing address

2201 S R ST
FORT SMITH AR
72901-5727
US

V. Phone/Fax

Practice location:
  • Phone: 479-388-0996
  • Fax:
Mailing address:
  • Phone: 682-215-9121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberL.AC.075
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: