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1013518877
JACOB MATLOCK
FORT SMITH, AR
NPI
1013518877
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: AR PD11121)
Enumeration Date
2020-11-06
Last Update Date
2020-11-06
Business Address
JACOB MATLOCK
2425 S ZERO ST
FORT SMITH, AR 72901-8663
Phone number: 479-646-4983
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Mailing Address
JACOB MATLOCK
479745 E 1100 RD
ROLAND, OK 74954-5069
Phone number:
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