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1760700694
ANTHONY RAPHAEL
BENTONVILLE, AR
NPI
1760700694
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2010-05-17
Last Update Date
2010-05-17
Business Address
-- ANTHONY RAPHAEL MHPP
2003 SE WALTON BLVD
BENTONVILLE, AR 72712-3725
Phone number: 479-464-5925
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Mailing Address
-- ANTHONY RAPHAEL MHPP
3352 N FUTRALL DR
FAYETTEVILLE, AR 72703-4057
Phone number: 479-521-1427
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