Individual
MR. LANCE GORDON CLOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
623 FAYETTEVILLE RD, VAN BUREN, AR 72956-3418
(479) 410-2225
(479) 410-9238
Mailing address
PO BOX 6577, VAN BUREN, AR 72956-0482
(479) 410-2225
(479) 410-9238
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1386
AR
363LF0000X
Family Nurse Practitioner
Primary
A004094
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203917758
—
AR
Enumeration date
03/21/2006
Last updated
07/18/2019
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