| NPI | 1730665779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGO JOHNSON Owner 501-730-4179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2018-07-12 |
| Last Update Date | 2018-07-12 |