Organization
ITI CHITO ENTERPRISES INC
Active
Other names
Lockesburg Family Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSTY LYNN GRIFFIN (OWNER)
(501) 765-0275
Entity
Organization
Contact information
Practice address
500 E COLLIN RAYE DR STE 2, DE QUEEN, AR 71832-8068
(870) 642-7257
(870) 642-5015
Mailing address
500 E. COLLIN RAYE DRIVE, DE QUEEN, AR 71832-8054
(870) 642-7257
(870) 642-5015
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
10/01/2021
Last updated
04/01/2022
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