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MR. DALE BRENT ADAMS

>> Contractor >> Other Service Providers

Registrant NPI Number: 1932359478

Individual Registrant:
MR. DALE BRENT ADAMS 
Gender: M
Sole Proprietor

Location and contact information for practice:
2313 ANVIL DR  HARRISON, AR 72601-8687 US
Tel: 870-391-2231  Fax: --

Contact information for business:
2313 ANVIL DR  HARRISON, AR 72601-8687 US
Tel: 870-391-2231  Fax: --

Registration Information:
NPI: 1932359478
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y171W00000XOther Service Providers
Contractor
N302F00000XManaged Care Organizations
Exclusive Provider Organization
AR

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
169609784AR05




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