| NPI | 1073640769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAELLE BRYANT Business Manager 501-804-9712 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AR MC2196) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2019-07-24 |