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1871813832
EVAN BURGESS
FAYETTEVILLE, AR
NPI
1871813832
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2010-06-01
Last Update Date
2010-06-01
Business Address
EVAN BURGESS MHPP
2805 E ZION RD
FAYETTEVILLE, AR 72703-5195
Phone number: 479-443-7105
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Mailing Address
EVAN BURGESS MHPP
3352 N FUTRALL DR
FAYETTEVILLE, AR 72703-4057
Phone number: 479-443-7105
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