Individual
DEVARON LAMAR ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1502 MARY KAY BLVD, BENTON, AR 72015-7201
(501) 315-3344
(510) 381-6118
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
(510) 381-6118
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/07/2014
Last updated
03/18/2020
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