Provider First Line Business Practice Location Address:
960 E BOWLES ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUMAS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71639-2508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-382-6100
Provider Business Practice Location Address Fax Number:
870-382-4535
Provider Enumeration Date:
10/03/2005