Healthcare Provider Details

I. General information

NPI: 1114131802
Provider Name (Legal Business Name): PILLOW CLINIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 SHIRLEY HICKS DR
HELENA AR
72342-8852
US

IV. Provider business mailing address

101 SHIRLEY HICKS DR
HELENA AR
72342-8852
US

V. Phone/Fax

Practice location:
  • Phone: 870-572-5996
  • Fax: 870-572-5996
Mailing address:
  • Phone: 870-572-5996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: TARA ADAMS
Title or Position: CLINIC MANAGER
Credential:
Phone: 870-572-5996