| NPI | 1528478849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOSEPH RABORN President 870-926-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AR R 3452) |
| Enumeration Date | 2014-05-08 |
| Last Update Date | 2014-05-08 |