Organization
CHANGE CENTER FOR VITALITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA VELEZ (PRESIDENT)
(501) 324-8649
Entity
Organization
Contact information
Practice address
400 W CAPITOL AVE, STE 100D, LITTLE ROCK, AR 72201-3436
(501) 324-2649
Mailing address
400 W CAPITOL AVE, STE 100D, LITTLE ROCK, AR 72201-3436
(501) 324-2649
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/12/2010
Last updated
07/12/2010
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