Than Demetrisus Andros AT

NPI 1235450172 - Counselor - 101Y00000X

NPI Details
NPI 1235450172
Gender Male
Enumeration Date 06/15/2010
Last Updated 06/15/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
417 W MAIN ST
STE B
TRUMANN AR, 72472-3116, US
Phone (870) 483-7039
Fax (870) 483-0590
Business Location
5537 BLEAUX AVE
SPRINGDALE AR, 72762-0737, US
Phone (479) 872-5580
Fax (479) 872-5581
Toxanomy
Taxonomy Code 101Y00000X
License State
License Number
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According to our database, Mr. Than Demetrisus Andros AT NPI is 1235450172, taxonomy code is 101Y00000X Than Demetrisus Andros AT physically located at 417 W Main St, Trumann AR, 72472-3116. NPI Number Than Demetrisus Andros AT has the Individual type.

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1235450172 NPI number is provided on an as is basis without warranty of any kind. 1235450172 is maintained by the National Plan & Provider Enumeration System. The contents of Than Demetrisus Andros AT are for informational purposes only.