Individual
BENJAMIN CALEB AUTHEMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1501 COLLEGE AVE, CONWAY, AR 72034-6401
(501) 205-8937
Mailing address
2302 COLLEGE AVE, CONWAY, AR 72034-6297
(501) 329-3831
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
300760
LA
2255A2300X
Athletic Trainer
Primary
AT996
AR
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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