Individual
MISS MIKA LARAY MCKINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
3733 N BUSINESS DR STE 101, FAYETTEVILLE, AR 72703-5286
(479) 443-5476
Mailing address
496 N CORAL CANYON LOOP APT 200, FAYETTEVILLE, AR 72704-6297
(918) 774-7255
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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