| NPI | 1639571201 |
|---|---|
| Doing Business As | HENDERSON STATE SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | ROB REDDING Asst. Athletics Director 870-230-5069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2014-09-25 |
| Last Update Date | 2014-09-25 |