| NPI | 1205410651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH WADDELL Asc Administrator 501-766-1065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2021-05-11 |