| NPI | 1104268689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY WELLS President 501-202-2080 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: AR c5558) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2017-12-12 |