Provider First Line Business Practice Location Address:
161 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUMAS
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
71639-2222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
870-382-4878
Provider Business Practice Location Address Fax Number:
870-382-4895
Provider Enumeration Date:
06/06/2007