LIDWINA WANGSADIPURA POWERS

JONESBORO, AR
NPI1124355623
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: AR  PA-753)
Additional Taxonomies363A00000X Physician Assistant
(Licence: CA  PA20529)
Enumeration Date2009-11-04
Last Update Date2024-07-25
Business Address
LIDWINA WANGSADIPURA POWERS PA-C
5510 SOUTHWEST DR STE 11-12
JONESBORO, AR 72404-8351
Phone number: 870-641-4471
Mailing Address
LIDWINA WANGSADIPURA POWERS PA-C
PO BOX 497
AUGUSTA, AR 72006-0497
Phone number: 870-347-2534