Healthcare Provider Details

I. General information

NPI: 1861735243
Provider Name (Legal Business Name): TRANQUILITY DAY SPA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27403 N STATE HWY 27 SOUTH SUITE B
POTTSVILLE AR
72834
US

IV. Provider business mailing address

PO BOX 156
DARDANELLE AR
72834-0156
US

V. Phone/Fax

Practice location:
  • Phone: 479-229-1315
  • Fax:
Mailing address:
  • Phone: 479-229-1315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305S00000X
TaxonomyPoint of Service
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY KILBURN
Title or Position: OWNER
Credential:
Phone: 479-229-1315