| NPI | 1578993291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WINSTON SHIELDS Owner 501-551-1666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: AR R81105) |
| Enumeration Date | 2013-11-15 |
| Last Update Date | 2013-11-15 |