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1336331974
TRAVELL GREEN
PRESCOTT, AR
NPI
1336331974
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2007-08-17
Last Update Date
2011-08-29
Business Address
-- TRAVELL GREEN MHPP
1484 W 1ST ST N
PRESCOTT, AR 71857-3339
Phone number: 870-887-1078
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Mailing Address
-- TRAVELL GREEN MHPP
3352 N FUTRALL DR
FAYETTEVILLE, AR 72703-4057
Phone number: 479-521-5868
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