Graduated: 2014
NPI: 1053722132
Practice Locations (2)
KETAMINE AND IV THERAPY CLINIC OF NWA LLC
101 GRANT PL, SUITE C
LOWELL, AR 727457103
4793182382
KETAMINE AND IV THERAPY CLINIC OF NWA LLC
1631 NE DOUGLAS ST, ASCEND WELLNESS
LEES SUMMIT, MO 640864701
8163812050
Source: CMS National Downloadable File, September 2026.