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1073848081
RUSTY WAYNE DAVIS
LITTLE ROCK, AR
NPI
1073848081
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2009-10-08
Last Update Date
2011-01-06
Business Address
Mr. RUSTY WAYNE DAVIS MHPP
11321 INTERSTATE 30 STE 104
LITTLE ROCK, AR 72209-7064
Phone number: 501-202-7587
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Mailing Address
Mr. RUSTY WAYNE DAVIS MHPP
11321 INTERSTATE 30 STE 104
LITTLE ROCK, AR 72209-7064
Phone number: 501-202-7587
Copy
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