Individual
KODI LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 SOUTHWINDS RD STE 120, FARMINGTON, AR 72730-8652
(479) 300-6400
Mailing address
3127 SOUTHWEST DR, JONESBORO, AR 72404-8404
(870) 336-8100
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
04/10/2024
Last updated
04/10/2024
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