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1124755715
JOHNATHAN SHANE ROACH
ARKADELPHIA, AR
NPI
1124755715
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-08-03
Last Update Date
2022-08-03
Business Address
JOHNATHAN SHANE ROACH
2607 CADDO ST STE 6
ARKADELPHIA, AR 71923-5307
Phone number: 870-230-8217
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Mailing Address
JOHNATHAN SHANE ROACH
2607 CADDO ST STE 6
ARKADELPHIA, AR 71923-5307
Phone number: 870-230-8217
Copy
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