NPI | 1467288530 |
---|---|
Entity Type | Organization |
Authorized Contact | MARION YORK Credentialing Specialist 501-246-4561 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2024-09-13 |
Last Update Date | 2025-04-21 |