| NPI | 1366422305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA SIMON Partner 870-367-6867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2020-04-01 |