Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 15705 | AR |
NPI | 1578895561 |
---|---|
Provider Name | Dr. Floyd Alan Powell |
First Address | Springdale, AR 72762-5708 |
Second Address | Springdale, AR 72762-6097 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2010 |
Last Update Date | 13/04/2010 |