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Individual

MISS VICTORIA TERESA FORTNER III

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12100 FIELDSTONE LN APT M65, BRYANT, AR 72022-6257
(501) 594-5200
(501) 594-5244
Mailing address
12100 FIELDSTONE LN APT M65, BRYANT, AR 72022-6257
(501) 350-4239
(501) 594-5244

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
03/05/2007
Last updated
07/08/2007
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