Whalio Doctors

NPI 1689883209

Superior Source INC

Organisation Contractor Little Rock, AR

Practice location

Address
78 Westminister Dr, Little Rock, AR 72209-2949
Phone
(501) 568-4785
Fax
(501) 562-0603

Authorised official

Name
Vernon Olandus Jordan
Title
President
Phone
(501) 568-4785

Registered specialties

Contractor Primary
Other Service Providers Taxonomy 171W00000X

Registry record

NPI
1689883209
Entity type
Organization
NPI issued
21 May 2007
Record last updated
22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.