Organization
DELTA WAVE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD TIMOTHY EVANS BS, CCT (PRESIDENT- DELTA WAVE, LLC)
(877) 840-1840
Entity
Organization
Contact information
Practice address
1 INNWOOD CIR, SUITE 102, LITTLE ROCK, AR 72211-2447
(501) 217-8200
(501) 217-8201
Mailing address
1 INNWOOD CIR, SUITE 102, LITTLE ROCK, AR 72211-2447
(501) 217-8200
(501) 217-8201
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
BL00033811
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053424523
NPI
AR
01
—
1649413949
NPI
AR
Enumeration date
06/10/2009
Last updated
12/15/2009
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