| NPI | 1255086898 |
|---|---|
| Doing Business As | REHYDRATION STATION AND AESTHETICS |
| Entity Type | Organization |
| Authorized Contact | KELLIE ANN CHACANACA Owner/Member 479-329-1194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2022-02-12 |
| Last Update Date | 2024-02-20 |