Organization
PINNACLE ALLERGY CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEANNA NICHOLSON RUDDELL MD (OWNER)
(501) 557-6445
Entity
Organization
Contact information
Practice address
16101 CANTRELL RD STE 104, LITTLE ROCK, AR 72223-4578
(501) 425-0322
Mailing address
16101 CANTRELL RD STE 104, LITTLE ROCK, AR 72223-4578
(501) 557-6445
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
N8430
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129401001
—
AR
Enumeration date
11/13/2017
Last updated
12/28/2017
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