| NPI | 1255746772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORWIN PETTY Physician / Owner 479-502-4435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AR E2717) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2014-06-23 |