| NPI | 1063903748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN K LEDBETTER D.O./ Owner 479-782-6318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AR T2018-104) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2018-05-29 |