Individual
KELLY HARVILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1016 W SOUTH ST STE 1, BENTON, AR 72015-4074
(501) 315-5100
Mailing address
1016 W SOUTH ST STE 1, BENTON, AR 72015-4074
(501) 315-5100
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PT11174
AR
Other
Enumeration date
02/01/2024
Last updated
02/01/2024
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