PROVIDENCE FAMILY MEDICINE CLINIC INC

CONWAY, AR
NPI1932690617
Entity TypeOrganization
Authorized ContactMOHAMMAD IDRIS
President
501-499-1086
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
Enumeration Date2018-05-29
Last Update Date2018-05-29
Business Address
PROVIDENCE FAMILY MEDICINE CLINIC INC
3900 DAVE WARD DR
CONWAY, AR 72034-5583
Phone number: 501-499-1086
Mailing Address
PROVIDENCE FAMILY MEDICINE CLINIC INC
8 OAK TREE CIR
CONWAY, AR 72032-2112
Phone number: 501-499-1086
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