Organization
IM A 10 WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIVONNE MARIE MCCARROLL (OFFICE MANAGER)
(501) 593-6997
Entity
Organization
Contact information
Practice address
404 LAKE WOOD DR, SEARCY, AR 72143-9056
(501) 593-6997
(501) 325-2912
Mailing address
404 LAKE WOOD DR, SEARCY, AR 72143-9056
(501) 593-6997
(501) 325-2912
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5940-C
AR
Other
Enumeration date
01/26/2017
Last updated
06/16/2018
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