Organization
W.A. LUCKY LLC.
Active
Other names
Acheive Medical Weightloss
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY WALKER (OWNER)
(479) 442-5677
Entity
Organization
Contact information
Practice address
1753 N COLLEGE AVE, STE. 100, FAYETTEVILLE, AR 72703-2650
(479) 442-5677
Mailing address
1753 N COLLEGE AVE, STE. 100, FAYETTEVILLE, AR 72703-2650
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
A003800
AR
Other
Enumeration date
04/02/2013
Last updated
04/02/2013
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