Provider First Line Business Practice Location Address:
JEFFERSON REGIONAL MEDICAL CENTER
Provider Second Line Business Practice Location Address:
1600 WEST 40TH
Provider Business Practice Location Address City Name:
PINE BLUFF
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
501-541-7100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/16/2007