| NPI | 1578559787 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY BURNETT Director 501-730-0754 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AR 041036) |
| Enumeration Date | 2005-09-22 |
| Last Update Date | 2020-08-22 |