Organization
NEA RELIANT HEALTH CARE PROFESSIONALS INC
Active
Other names
BONO FAMILY MEDICAL CLINIC AND THERAPY SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY BERGMAN (OWNER)
(870) 930-9990
Entity
Organization
Contact information
Practice address
9146 HIGHWAY 63 N, BONO, AR 72416-8153
(870) 930-9990
(870) 930-9992
Mailing address
9146 HIGHWAY 63 N, BONO, AR 72416-8153
(870) 930-9990
(870) 930-9992
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A003947
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083046445
NPI
AR
05
—
200136758
—
AR
Enumeration date
09/01/2015
Last updated
12/28/2016
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