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General NPI Number Information
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NPI Number | 1447705843
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Entity Type | Organization
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Legal Business Name | DERMAHEALING CONSULTANTS, LLC
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Dates
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Enumeration Date | 08/16/2016
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Last Update Date | 08/16/2016
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Provider Practice Location Address
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Address Line | 2217 WOODSPRINGS RD SUITE A
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City | JONESBORO
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State | AR
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Zip | 72404-8072
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Country | US
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Telephone | 870-520-6241
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Fax | 870-520-6254
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Provider Business Mailing Address
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Address Line | 2217 WOODSPRINGS RD SUITE A
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City | JONESBORO
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State | AR
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Zip | 72404-8072
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Country | US
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Telephone | 870-520-6241
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Fax | 870-520-6254
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | KRISTEN MCDANIEL
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Credential |
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Telephone | 870-520-6241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | AR
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