| NPI | 1023057916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN J BOWMAN Insurance Supervisor 870-536-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: AR 739) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2008-10-17 |