| NPI | 1881830727 |
|---|---|
| Other Name | WYNNE OUTPATIENT CLINIC |
| Entity Type | Organization |
| Authorized Contact | SHELLA POUNDS Compliance Officer 870-732-1878 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X (Licence: AR 171535526) |
| Enumeration Date | 2008-12-24 |
| Last Update Date | 2013-03-06 |