QUENTAVIOUS WILSON

CONWAY, AR
NPI1689006959
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2013-08-08
Last Update Date2013-08-08
Business Address
-- QUENTAVIOUS WILSON Recovery Assistant
132 LOWER RIDGE RD
CONWAY, AR 72032-8518
Phone number: 501-548-9905
Mailing Address
-- QUENTAVIOUS WILSON Recovery Assistant
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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