| NPI | 1285622845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSS GREENE Administrator 479-527-0050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AR AR4272) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2009-04-16 |