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General NPI Number Information
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NPI Number | 1578335139
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Entity Type | Organization
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Legal Business Name | LC AESTHETICS & WELLNESS, INC.
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Dates
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Enumeration Date | 10/26/2023
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 223 MAUMELLE VALLEY DR
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City | MAUMELLE
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State | AR
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Zip | 72113-7650
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Country | US
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Telephone | 501-749-4944
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Fax |
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Provider Business Mailing Address
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Address Line | 9228 MAUMELLE BLVD
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City | NORTH LITTLE ROCK
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State | AR
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Zip | 72113-6678
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Country | US
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Telephone | 501-471-7337
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | DONNA WRIGHT
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Credential | APRN
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Telephone | 501-831-6117
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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