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1790004190
MELISSA KELLY PENDERGRASS
JONESBORO, AR
NPI
1790004190
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2010-05-25
Last Update Date
2010-05-25
Business Address
-- MELISSA KELLY PENDERGRASS MHPP
1217 STONE ST
JONESBORO, AR 72401-4520
Phone number: 870-972-1268
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Mailing Address
-- MELISSA KELLY PENDERGRASS MHPP
PO BOX 566
MONETTE, AR 72447-0566
Phone number: 870-930-4890
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