Organization
PAIN MANAGEMENT & REHAB CONSULT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FELISHA F HARP (OFFICE MANAGER BILLING)
(479) 587-1753
Entity
Organization
Contact information
Practice address
2531 TINAS CROSSING, FAYETTEVILLE, AR 72703
(479) 587-8753
(479) 587-8754
Mailing address
PO BOX 9928, FAYETTEVILLE, AR 72701
(479) 587-8753
(479) 587-8754
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
E4333
AR
208VP0000X
Pain Medicine Physician
Primary
MC2421
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15611001
—
AR
Enumeration date
06/03/2006
Last updated
03/21/2008
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