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General NPI Number Information
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NPI Number | 1720892821
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Entity Type | Organization
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Legal Business Name | ARKANSAS PERMANENT COSMETICS AND BRICKHOUSE BODY ART INSTITUTE, LLC
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Dates
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Enumeration Date | 02/07/2025
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 12406 HIGHWAY 5 STE F
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City | CABOT
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State | AR
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Zip | 72023-7657
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Country | US
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Telephone | 501-500-0272
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Fax |
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Provider Business Mailing Address
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Address Line | 12406 HIGHWAY 5 STE F
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City | CABOT
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State | AR
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Zip | 72023-7657
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MIKAL MURDERS
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Credential |
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Telephone | 479-903-1268
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246Z00000X
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Taxonomy Name | Other Specialist/Technologist
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License Number |
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License Number State |
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