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1225348980
JACKIE LEON CHEATHAM
CALICO ROCK, AR
NPI
1225348980
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
146N00000X Emergency Medical Technician, Basic
(Licence: AR 16847)
Enumeration Date
2010-10-15
Last Update Date
2010-10-15
Business Address
-- JACKIE LEON CHEATHAM EMT
907 AR HWY 56
CALICO ROCK, AR 72519-0261
Phone number: 870-421-9494
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Mailing Address
-- JACKIE LEON CHEATHAM EMT
PO BOX 261 907 AR HWY 56
CALICO ROCK, AR 72519-0261
Phone number: 870-421-9494
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