| NPI | 1760937171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE L BOONE Owner 870-845-1933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A004771) |
| Enumeration Date | 2016-08-16 |
| Last Update Date | 2016-10-24 |