Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156F00000X | Technician/Technologist | ||
Y | 156F00000X | Technician/Technologist | AR |
NPI | 1295256352 |
---|---|
Provider Name | Jarrin Eugene Paryzek |
First Address | Pea Ridge, AR 72751-2726 |
Second Address | Fayetteville, AR 72703-4714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2017 |
Last Update Date | 29/06/2017 |