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1528039088
LANCE EDWARD VESTAL
ROGERS, AR
NPI
1528039088
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: AR OTR987)
Enumeration Date
2006-01-31
Last Update Date
2008-03-06
Business Address
Mr. LANCE EDWARD VESTAL OT
3625 W CHESTNUT ST
ROGERS, AR 72756
Phone number: 479-631-3955
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Mailing Address
Mr. LANCE EDWARD VESTAL OT
908 NW 8TH ST
BENTONVILLE, AR 72712
Phone number: 479-273-1141
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