| NPI | 1710922315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN LYNCH D.O. 870-972-4510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X (Licence: AR R4434) |
| Additional Taxonomies | 2085R0001X (Licence: AR E2457) |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2008-01-30 |