| NPI | 1750860409 |
|---|---|
| Doing Business As | WHITE RIVER HEALTH SPECIALTY CLINIC |
| Entity Type | Organization |
| Authorized Contact | SHAWNA BAXTER Provider Enrollment 870-262-5545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2024-05-02 |