Individual
AMY WALTHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
715 N COLLEGE AVE, EL DORADO, AR 71730-4403
(870) 863-7921
Mailing address
715 N COLLEGE AVE, EL DORADO, AR 71730-4403
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L038369
AR
Other
Enumeration date
10/31/2017
Last updated
10/31/2017
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