Individual
CLYDE DALTON GURLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
QBHP
Contact information
Practice address
3111 S 70TH ST, FORT SMITH, AR 72903-5017
(479) 452-6650
(479) 452-5847
Mailing address
PO BOX 11818, FORT SMITH, AR 72917-1818
(479) 452-6650
(479) 452-5847
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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