| NPI | 1073800926 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY R COLLINS Owner 870-722-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: AR C7070) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2011-06-29 |