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Organization
ARKANSAS
Active
Organization
ARKANSAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANA RENE FOLEY (MANAGING MEMBER)
(501) 690-1328
Entity
Organization
Contact information
Practice address
412 W 6TH AVE, PINE BLUFF, AR 71601-4136
(501) 690-1328
(501) 562-0327
Mailing address
2011 HILLSBOROUGH LN, LITTLE ROCK, AR 72212-3730
(501) 690-1328
(501) 562-0327
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
NULL
Other
Enumeration date
07/01/2013
Last updated
07/01/2013
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