Individual
PHAGEN LEEKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2792 S 2ND ST STE B, CABOT, AR 72023-7064
(870) 932-3600
Mailing address
2792 S 2ND ST STE B, CABOT, AR 72023-7064
(870) 932-3600
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
120253
AR
174400000X
Specialist
—
—
Other
Enumeration date
06/03/2013
Last updated
08/02/2019
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