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Core Empowerment Group LLC

Clinic/Center, Genetics in Benton, AR. Organization (NPI-2).

NPI number1962631523
StatusActive
Last updated in NPPESJul 3, 2009

Details

NPI
1962631523
Entity type
Organization (NPI-2)
Legal business name
Core Empowerment Group LLC
Organization subpart
No
Enumeration date
Jul 3, 2009
Last updated
Jul 3, 2009

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QG0250X Clinic/Center, GeneticsR-2220ARYes

Practice location

17724 Interstate 30
Ste 2
Benton, AR 72019-2907

Phone 501-920-7901 · Fax 501-325-3469

Mailing address

1201 Military Rd
Ste 2 Pmb 269
Benton, AR 72015-2908

Phone 501-920-7901 · Fax 501-325-3469

Authorized official

William R Collie
Coo
5019207901

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