Individual
LATASHA RENA VAN HEFLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1268 ELECTRIC AVE, SPRINGDALE, AR 72764-7498
(870) 336-8100
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
11/05/2020
Last updated
11/05/2020
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