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1104335223
KORY THATCH
JONESBORO, AR
NPI
1104335223
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-09-20
Last Update Date
2018-06-05
Business Address
KORY THATCH MHPP
1815 PLEASANT GROVE RD
JONESBORO, AR 72401-7870
Phone number: 870-933-6886
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Mailing Address
KORY THATCH MHPP
1425 W MAIN ST
WALNUT RIDGE, AR 72476-1431
Phone number: 870-886-5303
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