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1902292568
JEREMY DIAZ
FORT SMITH, AR
NPI
1902292568
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2015-04-10
Last Update Date
2015-04-10
Business Address
JEREMY DIAZ RDS
615 N 19TH ST
FORT SMITH, AR 72901-3319
Phone number: 479-785-4083
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Mailing Address
JEREMY DIAZ RDS
615 N 19TH ST
FORT SMITH, AR 72901-3319
Phone number: 479-785-4083
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