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1992246805
KELLY SMART
BENTON, AR
NPI
1992246805
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-03-10
Last Update Date
2017-03-10
Business Address
-- KELLY SMART
1502 MARY KAY BLVD
BENTON, AR 72015
Phone number: 501-303-3105
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Mailing Address
-- KELLY SMART
PO BOX 1589
BENTON, AR 72018-1589
Phone number: 501-303-3105
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