| NPI | 1588603351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN J BOWMAN Insurance Supervisor 870-536-4100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: AR AR4179) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2010-06-29 |