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1699736777
EXECUTIVE PARK SURGERY CENTER, LLC
FORT SMITH, AR
NPI
1699736777
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Entity Type
Organization
Authorized Contact
RANDY M ENNEN
President
479-424-2744
Organization Subpart ?
No
Primary Taxonomy
261QA1903X Clinic/Center, Ambulatory Surgical
Enumeration Date
2006-03-29
Last Update Date
2010-12-16
Business Address
EXECUTIVE PARK SURGERY CENTER, LLC
3314 S 70TH ST
FORT SMITH, AR 72903-5052
Phone number: 479-424-2744
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Mailing Address
EXECUTIVE PARK SURGERY CENTER, LLC
3314 S 70TH ST
FORT SMITH, AR 72903-5052
Phone number: 479-424-2744
Copy
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