| NPI | 1861909046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER DELISE TOWNSEND Office Manager 501-201-0204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: AR A003845) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-01-09 |