| NPI | 1073636551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA K FALWELL Office Manager 870-523-3053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AR 207Q00000X) |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2012-06-20 |