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Individual

MS. CASARA NICHOLE WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7922 OLIVE HILL DR, MABELVALE, AR 72103-3847
(501) 612-1876
Mailing address
11016 CHARLOTTE DR, MABELVALE, AR 72103-3054
(501) 352-9843

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
918660211
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
181047783
AR
Enumeration date
12/04/2010
Last updated
12/04/2010
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