Individual
RENA TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3205 W MAIN ST, RUSSELLVILLE, AR 72801-2301
(479) 280-1914
Mailing address
3205 W MAIN ST, RUSSELLVILLE, AR 72801-2301
(479) 280-1914
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
167
—
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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