Individual
JACK DWAYNE MCMILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
406 S WALTON BLVD, BENTONVILLE, AR 72712-5705
(479) 273-5080
Mailing address
406 S WALTON BLVD, BENTONVILLE, AR 72712-5705
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
AR14126
AR
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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