| NPI | 1225398480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT JEFFREY COLE Medical Director 870-559-2006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2018-01-11 |