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1790110575
ETHAN HAWKINS
RUSSELLVILLE, AR
NPI
1790110575
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2013-09-11
Last Update Date
2014-05-08
Business Address
ETHAN HAWKINS RECOVERY ASSISTANT
210 N SHAMROCK BLVD
RUSSELLVILLE, AR 72802-9658
Phone number: 501-315-3344
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Mailing Address
ETHAN HAWKINS RECOVERY ASSISTANT
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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