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 |