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2200 Bruce Street Ste 101 Conway AR 72034 | |
| (501) 470-7457 | |
| (501) 504-2105 |
| Full Name | |
|---|---|
| Speciality | Speech-language Pathologist |
| Location | 2200 Bruce Street, Conway, Arkansas |
| Authorized Official Name and Position | Chad Lairamore (ASSOCIATE DEAN) |
| Authorized Official Contact | 5018522911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2200 Bruce Street Ste 101 Conway AR 72034 Ph: (501) 470-7457 | 2200 Bruce Street Ste 101 Conway AR 72034 Ph: (501) 470-7457 |
| NPI Number | 1184387540 |
|---|---|
| Provider Enumeration Date | 10/21/2021 |
| Last Update Date | 03/21/2023 |
| Certification Date | 03/21/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184387540 | NPI | - | NPPES |
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