Individual
MAISON GRACE STICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
600 AUTUMN RD, LITTLE ROCK, AR 72211-3606
(501) 320-7776
(501) 320-7975
Mailing address
4301 W MARKHAM ST # 783, LITTLE ROCK, AR 72205-7101
(501) 686-8000
(501) 526-5148
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1080
AR
Other
Enumeration date
05/10/2022
Last updated
08/01/2024
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