Bristow, Jonathan Edward
Bristow, Jonathan Edward is an sole proprietor health care provider with primary practice located at 8404 Baseline Rd , Little Rock AR 72209-4339. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Bristow, Jonathan Edward can be contacted via phone (501) 663-0708.Contact Information
Primary practice address
8404 Baseline Rd
Little Rock AR 72209-4339
Phone: (501) 663-0708
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 105 | Arkansas |
Profile Details
| NPI number | 1083209803 |
|---|---|
| LBN Legal business name | Bristow, Jonathan Edward |
| Credentials | CIT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 3rd, 2021 |
| Last updated | Mar 3rd, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083209803 | NPPES |
| Arkansas | Other | 105 | QUALIFIED BEHAVIORAL HEALTH PROVIDER, CIT |
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