Individual
JIMMY LEON PHILLIPS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4425 JEFFERSON AVE, SUITE 106, TEXARKANA, AR 71854-1535
(870) 216-1700
(870) 772-5965
Mailing address
4425 JEFFERSON AVE, SUITE 106, TEXARKANA, AR 71854-1535
(870) 216-1700
(870) 772-5965
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/21/2008
Last updated
01/21/2008
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