Provider First Line Business Practice Location Address:
624 HOSPITAL DR
Provider Second Line Business Practice Location Address:
RADIOLOGY DEPT.
Provider Business Practice Location Address City Name:
MOUNTAIN HOME
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72653-2955
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-425-6322
Provider Business Practice Location Address Fax Number:
870-424-5859
Provider Enumeration Date:
02/06/2007