Organization
PURE BALANCE OF NWA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB BOYDSTUN DO (OWNER)
(432) 770-5923
Entity
Organization
Contact information
Practice address
3608 W SOUTHERN HILLS BLVD, ROGERS, AR 72758-8013
(479) 633-7052
Mailing address
3608 W SOUTHERN HILLS BLVD, ROGERS, AR 72758-8013
(479) 633-7052
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
08/05/2024
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