| NPI | 1417448242 |
|---|---|
| Doing Business As | WHITE RIVER HEALTH ENT CLINIC |
| Entity Type | Organization |
| Authorized Contact | SHAWNA BAXTER Provider Enrollment 870-698-1846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 231H00000X Audiologist |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2025-05-05 |