Organization
RUSSELLVILLE PRIMARY CARE CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MONTI L KIST (OWNER/PRESIDENT)
(479) 967-3980
Entity
Organization
Contact information
Practice address
2524 W MAIN ST, RUSSELLVILLE, AR 72801-2533
(479) 967-3980
(479) 967-6509
Mailing address
PO BOX 9010, RUSSELLVILLE, AR 72811-9010
(479) 967-3980
(479) 967-6509
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/02/2006
Last updated
05/13/2010
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