Individual
JENNIFER PROCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8 MEDICAL PLZ, MOUNTAIN HOME, AR 72653-2919
(870) 449-5177
(870) 449-5178
Mailing address
PO BOX 1776, MOUNTAIN HOME, AR 72654-1776
(870) 425-6901
(870) 424-8703
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
10/05/2007
Last updated
10/05/2007
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