| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KYLE HOLLAND | 1598369456 | 2020-11-22 |
| Entity Type | Individual |
| Provider Name | Kyle Holland |
| Practice Office Address | 1 UNIVERSITY OF ARKANSAS FAYETTEVILLE, AR US |
| Practice Office Telephone | 4795752000 |
| Mailing Address | 1522 N MERION WAY APT 101 FAYETTEVILLE, AR 727046269 US |
| Code | License No | State |
|---|---|---|
| 2255A2300X | ||
| 390200000X PRIMARY |