| NPI | 1528144318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA MICHELLE DUNCAN Credentialing Specialist 479-967-2322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 251C00000X |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2022-12-28 |