Trenn Devor Fountain SR.

NPI 1093841819 - Case Manager/Care Coordinator - 171M00000X

NPI Details
NPI 1093841819
Gender Male
Enumeration Date 02/26/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
6501 W 12TH ST
LITTLE ROCK AR, 72204-1511, US
Phone (501) 666-8686
Business Location
PO BOX 251970
LITTLE ROCK AR, 72225-1970, US
Phone (501) 666-8686
Fax (501) 660-6830
Taxonomy Code 171M00000X
License State
License Number
Remove 1093841819 NPI Number

According to our database, Mr. Trenn Devor Fountain SR. NPI is 1093841819, taxonomy code is 171M00000X Trenn Devor Fountain SR. physically located at 6501 W 12th St, Little Rock AR, 72204-1511. NPI Number Trenn Devor Fountain SR. has the Individual type.

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1093841819 NPI number is provided on an as is basis without warranty of any kind. 1093841819 is maintained by the National Plan & Provider Enumeration System. The contents of Trenn Devor Fountain SR. are for informational purposes only.