Organization
THE FUNCTIONAL PHARMACIST INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE CROUSE PHARMD (OWNER)
(870) 265-6603
Entity
Organization
Contact information
Practice address
401 MAIN ST, LAKE VILLAGE, AR 71653-1731
(870) 265-6603
Mailing address
401 MAIN ST, LAKE VILLAGE, AR 71653-1731
(870) 265-6603
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/06/2019
Last updated
11/26/2019
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