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General NPI Number Information
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NPI Number | 1396870226
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Entity Type | Organization
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Legal Business Name | MCCARRON THERAPY & CONSULTING SERVICES
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 505 DAVE WARD DR SUITE 3
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City | CONWAY
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State | AR
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Zip | 72032-7834
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Country | US
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Telephone | 501-730-0303
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Fax | 501-730-0313
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Provider Business Mailing Address
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Address Line | 505 DAVE WARD DR SUITE 3
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City | CONWAY
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State | AR
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Zip | 72032-7834
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Country | US
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Telephone | 501-730-0303
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Fax | 501-730-0313
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARILYN JOYCE SWOPE
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Credential |
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Telephone | 501-730-0303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | OTR1543
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License Number State | AR
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