NPI | 1417071572 |
---|---|
Entity Type | Organization |
Authorized Contact | GLEN CHRISTOPHER ROLLAND Billing Clerk 870-486-5464 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261Q00000X Clinic/Center (Licence: AR S27098) |
Enumeration Date | 2007-03-16 |
Last Update Date | 2008-07-10 |