Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 123434 | AR |
NPI | 1043840457 |
---|---|
Provider Name | Jessica Treat |
First Address | Hot Springs, AR 71901-8480 |
Second Address | Hot Springs, AR 71901-7778 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2020 |
Last Update Date | 24/01/2020 |