Individual
SQUIRREL FIELDS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
714A N 19TH ST, FORT SMITH, AR 72901-3322
(539) 269-3027
Mailing address
714A N 19TH ST, FORT SMITH, AR 72901-3322
(539) 269-3027
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
OK
Other
Enumeration date
12/03/2025
Last updated
12/04/2025
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