Provider First Line Business Practice Location Address:
JODIE PARTRIDGE CENTER
Provider Second Line Business Practice Location Address:
1180 HIGHWAY 165
Provider Business Practice Location Address City Name:
DUMAS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71639-0643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-382-4374
Provider Business Practice Location Address Fax Number:
870-382-6814
Provider Enumeration Date:
04/12/2007