| NPI | 1053490144 |
|---|---|
| Doing Business As | PEDIATRIC AND TEEN MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | ANES WILEY ABRAHAM President 870-763-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AR R3291) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2020-08-22 |