| NPI | 1275694663 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY MICHAEL ROMAN Medical Director 501-225-9966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AR 6971) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2020-08-22 |