NPI | 1285041434 |
---|---|
Other Name | WALMART CARE CLINIC 10-1153 |
Entity Type | Organization |
Authorized Contact | SOUJANYA PULLURU President 479-703-0468 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 363L00000X Nurse Practitioner |
Enumeration Date | 2014-07-21 |
Last Update Date | 2021-12-07 |