Individual
MR. RICKIE LYNN PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PD
Contact information
Practice address
197 E MAIN ST, FARMINGTON, AR 72730
(479) 267-4303
(479) 267-4311
Mailing address
3278 N GULLEY RD, FAYETTEVILLE, AR 72703
(479) 267-4303
(479) 267-4311
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PD6532
AR
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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