Individual
DESHANTRA MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 W 6TH AVE, PINE BLUFF, AR 71601-3931
(870) 377-4095
Mailing address
6720 DOLLARWAY RD APT 22, PINE BLUFF, AR 71602-3459
(870) 377-4095
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
143286
AR
Other
Enumeration date
03/13/2017
Last updated
03/13/2017
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