| NPI | 1821377995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE M. MARTINSON Physician 870-423-3774 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: AR N7648) |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2011-09-16 |