Individual
MR. RAYMOND JOHN SMALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
315 MC 6043, YELLVILLE, AR 72687-8494
(870) 565-0960
Mailing address
PO BOX 616, YELLVILLE, AR 72687-0616
(870) 565-0960
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
61179
AR
Other
Enumeration date
09/21/2007
Last updated
09/21/2007
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