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Organization

NWA SPINE AND ORTHOPAEDIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CYRIL ANTHONY RABEN M.D. (OWNER)
(479) 442-4495
Entity
Organization

Contact information

Practice address
350 E MILLSAP RD, FAYETTEVILLE, AR 72703-4098
(479) 442-4495
(479) 442-8178
Mailing address
350 E MILLSAP RD, FAYETTEVILLE, AR 72703-4098
(479) 442-4495
(479) 442-8178

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5C793
BCBS
AR
Enumeration date
05/04/2007
Last updated
10/30/2007
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