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1982097697
ETHAN HENDRICKS
BENTON, AR
NPI
1982097697
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2015-03-05
Last Update Date
2015-03-05
Business Address
-- ETHAN HENDRICKS Recovery Assistant
6701 HIGHWAY 67 BLDG 4
BENTON, AR 72015-8909
Phone number: 501-315-3344
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Mailing Address
-- ETHAN HENDRICKS Recovery Assistant
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-315-3344
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