Individual
ALLYCE MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1316 MAIN ST, VAN BUREN, AR 72956-4557
(479) 471-6892
(479) 471-6859
Mailing address
602 N WALTON BLVD, BENTONVILLE, AR 72712-4576
(479) 464-1060
(479) 271-6307
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/30/2012
Last updated
11/30/2012
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