Ethan Stockett MHPP

NPI 1285919670 - Case Manager/Care Coordinator - 171M00000X

NPI Details
NPI 1285919670
Gender Male
Enumeration Date 10/17/2011
Last Updated 10/17/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
121 SAWGRASS PT
HARRISON AR, 72601-3072, US
Phone (870) 391-3871
Fax (870) 391-3874
Business Location
3352 N FUTRALL DR
FAYETTEVILLE AR, 72703-4057, US
Phone (479) 521-1427
Fax (479) 521-6520
Toxanomy
Taxonomy Code 171M00000X
License State
License Number
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According to our database, Ethan Stockett MHPP NPI is 1285919670, taxonomy code is 171M00000X Ethan Stockett MHPP physically located at 121 Sawgrass Pt, Harrison AR, 72601-3072. NPI Number Ethan Stockett MHPP has the Individual type.

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1285919670 NPI number is provided on an as is basis without warranty of any kind. 1285919670 is maintained by the National Plan & Provider Enumeration System. The contents of Ethan Stockett MHPP are for informational purposes only.