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1114350931
KENNETH REDIC
CONWAY, AR
NPI
1114350931
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2013-08-15
Last Update Date
2013-08-15
Business Address
-- KENNETH REDIC Recovery Assistant
132 LOWER RIDGE RD
CONWAY, AR 72032-8518
Phone number: 501-548-9905
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Mailing Address
-- KENNETH REDIC Recovery Assistant
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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