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MONTICELLO, AR
NPI1336781228
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2019-10-11
Last Update Date2019-10-11
Business Address
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936 JORDAN DR
MONTICELLO, AR 71655-5728
Phone number: 870-460-0066
Mailing Address
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PO BOX 251970
LITTLE ROCK, AR 72225-1970
Phone number:
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