Organization
PETTY MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CORWIN PETTY MD (PHYSICIAN / OWNER)
(479) 502-4435
Entity
Organization
Contact information
Practice address
114 HARRISON AVE, SUITE C, LOWELL, AR 72745-9047
(479) 254-1005
(479) 668-4003
Mailing address
114 HARRISON AVE, SUITE C, LOWELL, AR 72745-9047
(479) 254-1005
(479) 668-4003
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
E2717
AR
Other
Enumeration date
06/23/2014
Last updated
06/23/2014
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