| NPI | 1093710220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN A BILIINGSLEY Owner/Operator 479-751-4743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AR MC 2363) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2020-08-22 |