| NPI | 1821749946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAYLA ROBINSON Corporate Compliance Officer 870-541-7395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-04-01 |