| NPI | 1497029466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH JONES Owner 870-425-2277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AR 2345) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2012-03-08 |