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NPI Code Detail

MEDICARE: ADAM STAY WOOD LMT.

MEDICARE: ADAM STAY WOOD LMT.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist9361AR

General Provider Information

NPI Number : 1558105288
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM STAY WOOD LMT.
Provider Business Mailing Address
First Line : 1501 E MISSION BLVD
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72701-2253
Country : US
Telephone Number : 870-376-6804
Fax Number :
Provider Business Practice Location Address
First Line : 1271 N STEAMBOAT DR STE 1
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72704-6263
Country : US
Telephone Number : 479-435-6834
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2024
Last Update Date : 06/19/2024

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Directions to “ ADAM STAY WOOD LMT.” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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