| NPI | 1104855261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA J CRAWFORD Office Administrator 479-967-9657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: AR 1836) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2006-07-01 |
| Last Update Date | 2011-11-01 |