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1992225072
JACK BOWEN GILLISON
FAYETTEVILLE, AR
NPI
1992225072
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-06-21
Last Update Date
2017-06-21
Business Address
JACK BOWEN GILLISON
4253 N CROSSOVER RD
FAYETTEVILLE, AR 72703-4593
Phone number: 479-442-8577
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Mailing Address
JACK BOWEN GILLISON
4253 N CROSSOVER RD
FAYETTEVILLE, AR 72703-4593
Phone number:
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