| NPI | 1255122602 |
|---|---|
| Doing Business As | PRESTIGE CARE - BLYTHEVILLE |
| Entity Type | Organization |
| Authorized Contact | BENJAMIN WAGNER CARLYLE Owner 479-498-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2025-05-15 |
| Last Update Date | 2025-06-26 |