| NPI | 1144493529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM PEYTON MILLER Owner 479-471-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AR E1002) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-04-08 |