Healthcare Provider Details

I. General information

NPI: 1508352295
Provider Name (Legal Business Name): ALLISON DROBENA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2018
Last Update Date: 07/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 W WALNUT ST STE A
ROGERS AR
72756-0359
US

IV. Provider business mailing address

3003 W WALNUT ST STE A
ROGERS AR
72756-0359
US

V. Phone/Fax

Practice location:
  • Phone: 479-631-9799
  • Fax: 479-631-9786
Mailing address:
  • Phone: 479-631-9799
  • Fax: 479-631-9786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number635
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: