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General NPI Number Information
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NPI Number | 1386043438
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Entity Type | Individual
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Provider Name | HOLLY GARRETT
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Gender | Female
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 6363 W WEDINGTON DR
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-5839
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Country | US
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Telephone | 479-800-3185
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Fax |
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Provider Business Mailing Address
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Address Line | 3195 N ADAMS RD
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-9395
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Country | US
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Telephone | 501-944-0790
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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