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Southeast Rehab Llc.
Gerontology Nurse Practitioner in Lake Village, Arkansas
NPI 1295276970

Southeast Rehab Llc. is a Gerontology Nurse Practitioner based in Lake Village, AR and is specialized in Gerontology. Southeast Rehab Llc. practices in Lake Village, AR. The NPI Number for Southeast Rehab Llc. is 1295276970 and holds a License No. (Arkansas).

The current practice location address for Southeast Rehab Llc. is 903 Borgognoni Dr, Lake Village, AR and can be reached out via phone at 318-665-9950.

Location: 903 Borgognoni Dr, Lake Village, AR, 71653-1623
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1295276970
Provider Name
Southeast Rehab Llc.
Credential
Provider Entity Type
Organization
Address
903 Borgognoni Dr, Lake Village, AR, 71653-1623
Phone Number
318-665-9950
Fax Number
Provider Enumeration Date
03/15/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
903 Borgognoni Dr
City
Lake Village
State
Arkansas
Zip
71653-1623
Phone Number
318-665-9950
Fax Number
person
Provider Business Mailing Address Details
Address
903 Borgognoni Dr
City
Lake Village
State
Arkansas
Zip
71653-1623
Phone Number
318-665-9950
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
363LG0600X
License No.
()
Definition
Definition to come...
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