| NPI | 1124366612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARON C PRAETZEL Owner 501-623-4485 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AR AR4822) |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2013-01-18 |