Provider First Line Business Practice Location Address:
213 ADAMS 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:
71639-2312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-382-4571
Provider Business Practice Location Address Fax Number:
870-382-4874
Provider Enumeration Date:
12/18/2006