Provider First Line Business Practice Location Address:
612 SOUTH 12TH ST.
Provider Second Line Business Practice Location Address:
FAMILY MEDICINE UAMS-WEST
Provider Business Practice Location Address City Name:
FORT SMITH
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-785-2431
Provider Business Practice Location Address Fax Number:
479-785-0732
Provider Enumeration Date:
03/23/2017