Individual
ELIZABETH MARIE SQUIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
201 SULLIVAN DR, BRYANT, AR 72022-3974
(501) 847-5605
Mailing address
6344 LENA DR, ALEXANDER, AR 72002-8033
(281) 678-1338
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/04/2022
Last updated
08/04/2022
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