| NPI | 1932586260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH JESSICA-ELISE COLUCCINO Office Manager 479-242-2888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AR E-7210) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2017-12-14 |