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1093004111
SHANE RIDENOUR
BARLING, AR
NPI
1093004111
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2011-03-29
Last Update Date
2011-03-29
Business Address
SHANE RIDENOUR
1311 FORT STREET
BARLING, AR 72923
Phone number: 479-452-5040
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Mailing Address
SHANE RIDENOUR
PO BOX 23070
BARLING, AR 72923-0070
Phone number: 479-452-5040
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