Individual
DARRELL SHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMP
Contact information
Practice address
522 MILL RD, CLARKSVILLE, AR 72830-8511
(479) 705-1301
Mailing address
PO BOX 1589, BENTON, AR 72018-1589
(501) 315-3344
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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