| NPI | 1437266152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUNE S NESBITT Credentialing Coordinator 479-986-3408 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2020-08-22 |