ETHAN GEORGE BASSHAM

SEARCY, AR
NPI1730563859
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2015-07-18
Last Update Date2015-07-18
Business Address
-- ETHAN GEORGE BASSHAM MHPP
400 LLAMA
SEARCY, AR 72143
Phone number: 501-305-2359
Mailing Address
-- ETHAN GEORGE BASSHAM MHPP
1815 PLEASANT GROVE ROAD
JONESBORO, AR 72404
Phone number: 870-933-6886
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