Provider Demographics
NPI:1831798859
Name:PAINTED ROCK HEALTH AND WELLNESS, LLC
Entity type:Organization
Organization Name:PAINTED ROCK HEALTH AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLNER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:501-658-8557
Mailing Address - Street 1:9421 W MARKHAM ST STE B
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2282
Mailing Address - Country:US
Mailing Address - Phone:501-658-8557
Mailing Address - Fax:833-727-5966
Practice Address - Street 1:9421 W MARKHAM ST STE B
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2282
Practice Address - Country:US
Practice Address - Phone:501-658-8557
Practice Address - Fax:833-727-5966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty