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1588302145
LARRY HICKS
MALVERN, AR
NPI
1588302145
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2022-05-24
Last Update Date
2022-05-24
Business Address
LARRY HICKS
1628 E PAGE AVE
MALVERN, AR 72104-4524
Phone number: 501-315-3344
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Mailing Address
LARRY HICKS
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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