Individual
MISS JENNIFER ANN SPORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
624 HOSPITAL DR, MOUNTAIN HOME, AR 72653-2955
(870) 424-1424
(870) 424-1355
Mailing address
624 HOSPITAL DR, MOUNTAIN HOME, AR 72653-2955
(870) 424-1425
(870) 424-1355
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1145
AR
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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