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1679159289
IAN K ANTONIO
FAYETTEVILLE, AR
NPI
1679159289
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2021-03-23
Last Update Date
2021-03-23
Business Address
IAN K ANTONIO
60 W SUNBRIDGE DR
FAYETTEVILLE, AR 72703-1822
Phone number: 479-695-1240
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Mailing Address
IAN K ANTONIO
60 W SUNBRIDGE DR
FAYETTEVILLE, AR 72703-1822
Phone number: 479-695-1240
Copy
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