| NPI | 1992992085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY M WILLIAMS Credentialing Services Coordinator 870-934-5117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-11-12 |