Provider First Line Business Practice Location Address:
305 S PALM
Provider Second Line Business Practice Location Address:
ARKANSAS STATE HOSPITAL
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-686-9407
Provider Business Practice Location Address Fax Number:
501-686-9298
Provider Enumeration Date:
03/16/2011