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1578920369
BRIAN TACKETT
JONESBORO, AR
NPI
1578920369
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: AR OT2015-047)
Enumeration Date
2016-01-25
Last Update Date
2016-01-25
Business Address
-- BRIAN TACKETT
3005 APACHE DR
JONESBORO, AR 72401-7432
Phone number: 870-336-0238
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Mailing Address
-- BRIAN TACKETT
3005 APACHE DR
JONESBORO, AR 72401-7432
Phone number: 870-336-0238
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