NPI | 1568647519 |
---|---|
Doing Business As | NORTHSIDE CLINIC AT 6TH STREET |
Entity Type | Organization |
Authorized Contact | JERRY J. WHITE Executive Director 479-431-2057 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2008-01-08 |
Last Update Date | 2020-06-08 |