Individual
JILL R VANDESTEEG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
333 MADISON ST, CLARENDON, AR 72029
(870) 747-3304
Mailing address
525 MARTIN ST, CLARENDON, AR 72029-2112
(870) 747-3350
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
PT88675
AR
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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