Provider First Line Business Practice Location Address:
2200 FORT ROOTS DRIVE
Provider Second Line Business Practice Location Address:
CENTRAL ARK VA HEALTHCARE 122 NLR
Provider Business Practice Location Address City Name:
NO LITTLE ROCK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-257-3341
Provider Business Practice Location Address Fax Number:
501-257-3329
Provider Enumeration Date:
09/15/2006