OrganizationActive
Defy Age Med Spa, PLLC
NPI 1407515141 · Pain Medicine (Anesthesiology) Physician · Conway, AR
Provider details
- NPI number
- 1407515141
- Entity type
- Organization
- Primary specialty
- Pain Medicine (Anesthesiology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Heather Whaley, Owner(501) 554-6005
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
2501 Dave Ward Dr Ste A17
Conway, AR 72034-6090
Phone: (501) 499-9252
Approximate (ZIP-level) locationGet directions
Mailing address
2501 Dave Ward Dr Ste A17
Conway, AR 72034-6090
Registry dates
- Enumerated
- 2021-12-09
- Last updated
- 2021-12-09
- Certified
- 2021-12-09
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.