| NPI | 1003949694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL CRAIG MARTIN Owner And Operator 918-322-9510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 2180) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2009-05-27 |