Individual
OLLIE DWAYNE LUNBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2402 N COLLEGE AVE, FAYETTEVILLE, AR 72703-3308
(479) 251-1872
(479) 251-1947
Mailing address
1720 GRACE PL, BENTONVILLE, AR 72713-3070
(870) 930-6903
(479) 251-1947
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD08303
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206422407
—
AR
Enumeration date
12/04/2020
Last updated
12/04/2020
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