Individual
DR. ISABELL KESARI GERVAIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MBBS, HMD, OMD, NMD
Contact information
Practice address
4210 N FRONTAGE RD, SUITE B, FAYETTEVILLE, AR 72703-5001
(479) 249-8200
(479) 249-8201
Mailing address
4210 N FRONTAGE RD, SUITE B, FAYETTEVILLE, AR 72703-5001
(479) 249-8200
(479) 249-8201
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
1640
AL
175F00000X
Naturopath
Primary
1640
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558604819
—
AR
Enumeration date
04/04/2013
Last updated
11/21/2013
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