NPI | 1467817148 |
---|---|
Entity Type | Organization |
Authorized Contact | SOMA GHOSH Office Manager 870-391-5903 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AR MC-3097) |
Enumeration Date | 2015-12-22 |
Last Update Date | 2015-12-22 |