| NPI | 1154049989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN LAUREL GOODNIGHT Owner/Family Nurse Practitioner 479-216-1016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2024-05-30 |