| NPI | 1528370772 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNDA P JOHNSON Incorporator/Organizer 501-219-1725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2010-07-04 |
| Last Update Date | 2010-07-04 |