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1790048791
JERRY FORD
CLARKSVILLE, AR
NPI
1790048791
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2012-06-25
Last Update Date
2012-06-25
Business Address
-- JERRY FORD Recovery Assistant
522 MILL RD
CLARKSVILLE, AR 72830-8511
Phone number: 479-705-1301
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Mailing Address
-- JERRY FORD Recovery Assistant
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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