| NPI | 1407354780 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED S UR REHMAN Medical Director 479-420-5742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2024-09-05 |