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1124267166
JUSTIN KYLE LEE
RUSSELLVILLE, AR
NPI
1124267166
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2009-02-16
Last Update Date
2009-02-16
Business Address
-- JUSTIN KYLE LEE
110 SKYLINE DR
RUSSELLVILLE, AR 72801-3362
Phone number: 479-968-1298
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Mailing Address
-- JUSTIN KYLE LEE
1404 E 16TH ST
RUSSELLVILLE, AR 72802-2648
Phone number: 479-967-2022
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