| NPI | 1235194689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN G BEARD Billing Manager 479-478-7059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: AR N8359) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR R3835) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2007-11-19 |