| NPI | 1932539624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACI IVEY Proprietor/Physician 479-657-6501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AR R-4023) |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2013-11-18 |