| NPI | 1720723513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYN BLADDICK Human Resources 479-310-5206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical | |
| Enumeration Date | 2022-05-05 |
| Last Update Date | 2022-07-11 |