| NPI | 1982037016 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONI TACKETT WOMBLE Owner 870-898-5037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AR A003233) |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2016-01-27 |