Individual
JACENT LAMONT WINSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13718 TRETHORNE CIR, NORTH LITTLE ROCK, AR 72117-5052
(501) 606-1498
(501) 400-7993
Mailing address
PO BOX 166242, LITTLE ROCK, AR 72216-6242
(501) 606-1498
(501) 400-7993
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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