Provider First Line Business Practice Location Address:
788 SCOGIN DRIVE
Provider Second Line Business Practice Location Address:
DREW MEMORIAL HEALTH SYSTEM
Provider Business Practice Location Address City Name:
MONTICELLO
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-500-0595
Provider Business Practice Location Address Fax Number:
870-535-2801
Provider Enumeration Date:
08/19/2006