| NPI | 1083882633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY FRIZIELLE Billing Manager/ Nurse 870-535-4221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AR C5066) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2013-11-15 |