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Other Service Providers Case Manager/Care Coordinator

Provider NPI: 1023385861

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
2707 BROWNS LN  JONESBORO, AR 72401-7213 US
Tel: 870-972-4939  Fax: 870-972-4911

Business Mailing Address:
2707 BROWNS LN  JONESBORO, AR 72401-7213 US
Tel: 870-972-4939  Fax: 870-972-4911

NPI Information:
NPI: 1023385861
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y171M00000XOther Service Providers
Case Manager/Care Coordinator

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 171M00000X





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