Individual
LIEN VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2503 W PLEASANT GROVE RD, ROGERS, AR 72758-1448
(479) 936-8079
(479) 936-8657
Mailing address
2503 W PLEASANT GROVE RD, ROGERS, AR 72758-1448
(479) 936-8079
(479) 936-8657
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
5302036200
MI
183500000X
Pharmacist
Primary
PD11197
AR
Other
Enumeration date
09/03/2011
Last updated
09/03/2011
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