Organization Name:  LITTLE ROCK ALLERGY & ASTHMA CLINIC PA


Practice Location:
18 CORPORATE HILL DR SUITE 110 LITTLE ROCK, AR 72205 US
Tel: 501-224-1156  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
Y	207K00000X	Physicians Allergy & Immunology	AR	MC0750

Other Provider Identifiers:

Issuer	Number	State	Type
	104919002	AR	05

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin