| NPI | 1326389404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNY J STOVER Vice President Finance 479-338-2230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2013-03-14 |
| Last Update Date | 2018-04-02 |