NPI | 1962015859 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL WAYNE LANSDELL Clinic Adminstrator 870-584-1055 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
Enumeration Date | 2020-08-28 |
Last Update Date | 2020-09-03 |