Provider First Line Business Practice Location Address:
POB 1437 SLOT H-61
Provider Second Line Business Practice Location Address:
ARKANSAS DEPT OF HEALTH
Provider Business Practice Location Address City Name:
LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72203-1437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-280-4127
Provider Business Practice Location Address Fax Number:
501-280-4140
Provider Enumeration Date:
12/26/2006