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Individual

GRANT WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
25 GAP RD, BATESVILLE, AR 72501-8679
(870) 793-8900
Mailing address
25 GAP RD, BATESVILLE, AR 72501-8679

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
06/05/2015
Last updated
06/05/2015
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