Provider First Line Business Practice Location Address:
140 W. FRONT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72562
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-799-3035
Provider Business Practice Location Address Fax Number:
870-799-3863
Provider Enumeration Date:
10/11/2006