NPI | 1598108094 |
---|---|
Entity Type | Organization |
Authorized Contact | MORGAN THOMAS SENSABAUGH Owner/Provider 870-569-4954 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AR 16020) |
Enumeration Date | 2013-04-15 |
Last Update Date | 2015-05-06 |