Provider First Line Business Practice Location Address:
8811 HWY 65 SOUTH
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:
71639-0887
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-382-4818
Provider Business Practice Location Address Fax Number:
870-382-1048
Provider Enumeration Date:
08/10/2007