Organization
RADIANT VIBE WELLNESS SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
APRIL J ELLIS NP (NURSE PRACTITIONER)
(501) 565-1888
Entity
Organization
Contact information
Practice address
2800 S UNIVERSITY AVE, LITTLE ROCK, AR 72204-6006
(501) 565-1888
Mailing address
PO BOX 6038, JACKSONVILLE, AR 72078-6038
(501) 565-1888
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A03714
TX
Other
Enumeration date
09/10/2015
Last updated
09/10/2015
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