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Individual

AUSTIN SEWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3710 N STATE LINE AVE, TEXARKANA, AR 71854-1934
(870) 773-5521
Mailing address
3 LAMBETH CIR, TEXARKANA, TX 75503-2556
(903) 556-7111

Taxonomy

Speciality
Code
Description
License number
State
1835P2201X
Ambulatory Care Pharmacist
Primary
PD15889
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PD15889
PHARMACIST LICENSE
AR
Enumeration date
01/31/2022
Last updated
01/31/2022
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