| NPI | 1588473334 |
|---|---|
| Doing Business As | NUTT WALLEY CLINIC |
| Entity Type | Organization |
| Authorized Contact | DAN MANTZ CEO 870-352-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |