Organization
CORE EMPOWERMENT GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM R COLLIE IV M.D. (COO)
(501) 920-7901
Entity
Organization
Contact information
Practice address
17724 INTERSTATE 30, STE 2, BENTON, AR 72019-2907
(501) 920-7901
(501) 325-3469
Mailing address
1201 MILITARY RD, STE 2 PMB 269, BENTON, AR 72015-2908
(501) 920-7901
(501) 325-3469
Taxonomy
Speciality
Code
Description
License number
State
261QG0250X
Genetics Clinic/Center
Primary
R-2220
AR
Other
Enumeration date
07/03/2009
Last updated
07/03/2009
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