Healthcare Provider Details

I. General information

NPI: 1285756338
Provider Name (Legal Business Name): KIMBERLY MARIE SCHWIGER B.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2526 HIGHWAY 65 S SUITE #202
CLINTON AR
72031-6657
US

IV. Provider business mailing address

2270 MEADOWLAKE RD #609
CONWAY AR
72032-2562
US

V. Phone/Fax

Practice location:
  • Phone: 501-745-4584
  • Fax:
Mailing address:
  • Phone: 501-269-8377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: