Individual
MICHELLE ANNA DETKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2601 GENE GEORGE BLVD, SPRINGDALE, AR 72762-0845
(479) 725-6800
(479) 725-6582
Mailing address
2601 GENE GEORGE BLVD, SPRINGDALE, AR 72762-0845
(479) 725-6800
(479) 725-6582
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
PA-1450
AR
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/02/2020
Last updated
05/06/2026
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