| NPI | 1578906152 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TORRANCE S WALKER Owner 870-534-8515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AR 3626) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2013-04-12 |