Provider First Line Business Practice Location Address:
112 SOUTH 5TH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HERBER SPRINGS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72543-3816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-547-9994
Provider Business Practice Location Address Fax Number:
888-898-8972
Provider Enumeration Date:
02/11/2009