Individual
MR. CLEVELAND LEE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1810 SUMAC ST, SMACKOVER, AR 71762-2412
(870) 725-2528
Mailing address
1810 SUMAC ST, SMACKOVER, AR 71762-2412
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2343
AR
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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