| NPI | 1851366777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MARK LOCHALA Owner 479-394-7301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-10-06 |