Organization
NORTH LITTLE ROCK PET ASSOCIATES, LLC
Active
Other names
CENTRAL AR PET
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDY WICKERSHAM (VP OF OPERATIONS)
(404) 418-2200
Entity
Organization
Contact information
Practice address
3500 SPRINGHILL DR, STE 100, N LITTLE ROCK, AR 72117-2950
(501) 687-1154
(501) 687-1289
Mailing address
PO BOX 15603, LITTLE ROCK, AR 72231-5603
(501) 687-1154
(501) 687-1289
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
ARK-991-AP-BP-08-12
AR
Other
Enumeration date
03/29/2006
Last updated
08/22/2020
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