Healthcare Provider Details

I. General information

NPI: 1700712858
Provider Name (Legal Business Name): APPELLO HEALTH AND WELLNESS CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

942 HIGHWAY 65 N STE B
MARSHALL AR
72650-7772
US

IV. Provider business mailing address

942 HIGHWAY 65 N STE B
MARSHALL AR
72650-7772
US

V. Phone/Fax

Practice location:
  • Phone: 501-337-9031
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASON WAYNE LEE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 501-772-7518