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1053655670
WALLACE MONTGOMERY
PINE BLUFF, AR
NPI
1053655670
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-11-20
Last Update Date
2012-11-20
Business Address
-- WALLACE MONTGOMERY
620 S LAUREL ST
PINE BLUFF, AR 71601-4859
Phone number: 870-534-4900
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Mailing Address
-- WALLACE MONTGOMERY
620 S LAUREL ST
PINE BLUFF, AR 71601-4859
Phone number: 870-534-4900
Copy
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