Provider First Line Business Practice Location Address:
11901 HWY 49 N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARMADUKE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-597-2911
Provider Business Practice Location Address Fax Number:
870-597-2217
Provider Enumeration Date:
06/13/2006