Provider First Line Business Practice Location Address:
600 E KINGSHIGHWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARAGOULD
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72450-4537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-243-8160
Provider Business Practice Location Address Fax Number:
870-335-2350
Provider Enumeration Date:
12/31/2025