Individual
JACOB RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
353 E 8TH ST, MOUNTAIN HOME, AR 72653-4423
(870) 701-5141
Mailing address
PO BOX 299, HOXIE, AR 72433-0299
(870) 886-1333
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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