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PHYLLIS D RACY BS
>> Case Manager/Care Coordinator >> Other Service ProvidersRegistrant NPI Number: 1578232203
Individual Registrant: PHYLLIS D RACY BS
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
612 E ARKANSAS ST STAR CITY, AR 71667-4842 US
Tel: 870-628-4181 Fax: 870-568-2444
Tel: 870-628-4181 Fax: 870-568-2444
Contact information for business:
2500 RIKE DR PINE BLUFF, AR 71603-3937 US
Tel: 870-534-1834 Fax: 870-534-5798
Tel: 870-534-1834 Fax: 870-534-5798
Registration Information:
NPI: 1578232203
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 171M00000X | Other Service Providers Case Manager/Care Coordinator |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
