DANIEL WILLIAM VAN DYCK

CROSSETT, AR
NPI1780041244
Professional NameDANIEL WILLIAM VAN DYCK
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy314000000X Skilled Nursing Facility
(Licence: AR  pta 2602)
Enumeration Date2016-01-28
Last Update Date2016-01-29
Business Address
-- DANIEL WILLIAM VAN DYCK PTA
118 JERRY SELBY DR
CROSSETT, AR 71635-4734
Phone number: 870-364-1534
Mailing Address
-- DANIEL WILLIAM VAN DYCK PTA
118 JERRY SELBY DR
CROSSETT, AR 71635-4734
Phone number: 870-364-1534