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Individual

JOSEPH KENT TETIRICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APN

Contact information

Practice address
5808 CALLAWAY LN, FORT SMITH, AR 72916-8437
(423) 426-3918
Mailing address
132 OAK GROVE RD, VAN BUREN, AR 72956-8410
(501) 772-0177

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
A003816
AR

Other

Enumeration date
02/08/2013
Last updated
02/08/2013
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