NPI | 1083325757 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD HENRY Enrollment Manager 479-258-2080 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2022-12-13 |
Last Update Date | 2022-12-13 |