| NPI | 1114107000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LEWIS Owner 479-306-4300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AR N8070) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2007-11-07 |