NPI | 1184839631 |
---|---|
Entity Type | Organization |
Authorized Contact | LINDA FAY WOODS Owner 501-952-7940 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: AR r35327) |
Enumeration Date | 2007-05-10 |
Last Update Date | 2013-01-07 |