| NPI | 1912728007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE HENRY VP, Chief Financial Officer 870-508-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-10-21 |
| Last Update Date | 2024-10-21 |