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1740686500
VAN WITHERSPOON
CONWAY, AR
NPI
1740686500
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2014-11-06
Last Update Date
2014-11-06
Business Address
-- VAN WITHERSPOON MHPP
1014 MAIN ST
CONWAY, AR 72032-5426
Phone number: 501-336-0511
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Mailing Address
-- VAN WITHERSPOON MHPP
1014 MAIN ST
CONWAY, AR 72032-5426
Phone number: 501-336-0511
Copy
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