| NPI | 1104084599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J LONG Owner 501-225-8346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: AR E-2576) |
| Enumeration Date | 2008-06-02 |
| Last Update Date | 2014-04-24 |