Individual
BECKY TADLOCK ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.D.
Contact information
Practice address
1766 WEST LAUREL, ROGERS, AR 72758
(479) 721-7390
Mailing address
1766 WEST LAUREL, ROGERS, AR 72758
(479) 721-7390
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
07555
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PD07444
ARKANSAS PHARMACIST LISCENSE
AR
Enumeration date
08/01/2013
Last updated
08/01/2013
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