Individual
MRS. RENE D. BADER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1760 N WOODLAND AVE, FAYETTEVILLE, AR 72703-2549
(479) 443-4420
(479) 443-0547
Mailing address
4107 CLARK AVE, SPRINGDALE, AR 72762-5865
(479) 751-6059
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT 767
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5U362
AR BC/BS PROVIDER NUMBER
AR
Enumeration date
04/28/2006
Last updated
07/09/2007
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