| NPI | 1023356342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASEY L BRUNDIDGE Practioner 580-279-1788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 1618) |
| Enumeration Date | 2013-01-21 |
| Last Update Date | 2013-02-07 |