| NPI | 1295933224 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY LYNN GREENLEE Office Manager 870-741-4295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: AR E2493) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2008-03-26 |