FUNCTIONAL HEADACHE AND WELLNESS MEDICINE NPI 1053244517

NPI Information

  • NPI: 1053244517
  • Provider Name: FUNCTIONAL HEADACHE AND WELLNESS MEDICINE
  • Classification: Clinic/Center - 261QH0100X
  • Specialization: Health Service
  • Entity Type: Organization
  • Address: 79 LAWRENCE ROAD 1315
    BLACK ROCK, AR
    ZIP 72415
  • Phone: (870) 878-2188

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NPI Details

FUNCTIONAL HEADACHE AND WELLNESS MEDICINE is a health service clinic center in Black Rock, AR. FUNCTIONAL HEADACHE AND WELLNESS MEDICINE NPI is 1053244517. The provider is registered as an organization entity type.

The provider's business location address is:

79 LAWRENCE ROAD 1315
BLACK ROCK, AR
ZIP 72415-158
Phone: (870) 878-2188

The provider's authorized official is Amy Freeman .
The authorized official title is Owner and has the following contact phone number (870) 878-2188.

The enumeration date for this NPI number is 6/4/2026 and was last updated on 6/4/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QH0100XClinic/CenterHealth ServiceYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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