| NPI | 1972178275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT SANCHEZ CEO 479-263-2690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2021-05-20 |