DIFFINE FAMILY PRACTICE PLLC
Marriage and Family Therapists in Blytheville, AR

License number
Arkansas E-3767
Category
Osteopathic Medicine
Type
Family Medicine
Owner
Name: DAVID A DIFFINE M.D,
Title: PRESIDENT
Phone: (870) 824-2809
Address
Address 2
1100 Medical Plaza Dr SOUTH SUITE C, Blytheville, AR 72315
PO Box 70, Caruth, MO 63857
National Provider ID: 1962707158
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DIFFINE FAMILY PRACTICE, PLLC

Paragould, AR  -  Blytheville, AR

Industry:
Medical Doctor's Office
Doing business as:
DIFFINE FAMILY PRACTICE PLLC
Registration:
Nov 19, 2010
Addresses:
5 Marketplace, Paragould, AR 72450 (Physical)
118 W Walnut St, Blytheville, AR 72315 (Physical)
5 Market Pl, Paragould, AR 72450
State ID:
800189010
Business type:
Limited Liability Company
Incorporator/Organizer:
David A. Diffine (Incorporator/Organizer)
Agent:
Mandy N. Meadors,118 W Walnut St, Blytheville, AR 72315 (Physical)
Filled under act:
Domestic LLC; 1003 of 1993

Marriage and Family Therapists licenses in Arkansas






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