| NPI | 1639622699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER MITCHELL Ncpdp COO Rdinator 479-636-9702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA G74906) |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2016-08-19 |