| NPI | 1275960155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRED E WILSON Medical Director 501-225-7468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: AR C-5114) |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2013-10-09 |