Individual
JACKIE LEON CHEATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EMT
Contact information
Practice address
907 AR HWY 56, CALICO ROCK, AR 72519-0261
(870) 421-9494
Mailing address
PO BOX 261, 907 AR HWY 56, CALICO ROCK, AR 72519-0261
(870) 421-9494
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
16847
AR
Other
Enumeration date
10/15/2010
Last updated
10/15/2010
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