Provider Demographics
NPI:1114506466
Name:WETHINGTON MANAGEMENT
Entity Type:Organization
Organization Name:WETHINGTON MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WETHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, CCC-A
Authorized Official - Phone:501-940-5373
Mailing Address - Street 1:24113 WHIPPORWILL LN
Mailing Address - Street 2:
Mailing Address - City:BAUXITE
Mailing Address - State:AR
Mailing Address - Zip Code:72011-9555
Mailing Address - Country:US
Mailing Address - Phone:501-940-5373
Mailing Address - Fax:
Practice Address - Street 1:7500 DOLLARWAY RD STE 103
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-3082
Practice Address - Country:US
Practice Address - Phone:870-247-8800
Practice Address - Fax:870-247-8802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No332S00000XSuppliersHearing Aid Equipment