NPI | 1568941433 |
---|---|
Entity Type | Organization |
Authorized Contact | THOMAS A. LANGSTON President/Incorporator 870-399-0077 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C7305) |
Enumeration Date | 2018-08-10 |
Last Update Date | 2020-07-23 |