Organization
NORTHWEST ARKANSAS FUNCTIONAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT RUSH (ARPN)
(479) 220-9951
Entity
Organization
Contact information
Practice address
246 S MAESTRI RD STE 2, TONTITOWN, AR 72762-9703
(479) 220-9909
(888) 675-9637
Mailing address
20398 BILL YOUNG RD, SILOAM SPRINGS, AR 72761-8921
(479) 220-9909
(888) 675-9637
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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