Individual
JASON MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMP
Contact information
Practice address
6701 HIGHWAY 67 BLDG 70, BENTON, AR 72015-8909
(501) 315-3344
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
AR
Other
Enumeration date
01/30/2009
Last updated
01/30/2009
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