| NPI | 1740695576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DREW W. TOOLE Owner 870-879-4870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: AR AR2324) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2014-07-01 |