| NPI | 1386177376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITNEY DESHAE SMITH Administrator 501-312-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2020-10-13 |