| NPI | 1942369327 |
|---|---|
| Doing Business As | PEDIATRIC NUTRITIONAL PROVIDERS |
| Entity Type | Organization |
| Authorized Contact | RHONDA PENNICK Manager 501-318-1110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR 253101-62-001) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |