| NPI | 1396783338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELISHA F HARP Office Manager Billing 479-587-1753 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X (Licence: AR MC2421) |
| Additional Taxonomies | 174400000X Specialist (Licence: AR E4333) |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2008-03-21 |