Organization · Type 2 NPI
Functional Headache and Wellness Medicine
Health Service Clinic/Center · Black Rock, AR
NPI number
1053244517
Active
Practice location
79 Lawrence Road 1315
Black Rock, AR 72415-9158
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health Service Clinic/Center Primary | 261QH0100X | None listed |
Health Service Clinic/Center: Definition to come...
About NPI 1053244517
Functional Headache and Wellness Medicine's National Provider Identifier is 1053244517, issued on Jun 4, 2026. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Black Rock, AR. The record was last updated on Jun 4, 2026.