Individual
MRS. FELICIA ANNA CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
636 W BROADWAY ST, NORTH LITTLE ROCK, AR 72114-5526
(501) 374-1153
(501) 374-6213
Mailing address
201 MAY ST, SHERWOOD, AR 72120-3814
(501) 833-3553
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
4643
AR
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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