NPI | 1023788098 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENT KEITH HOLLIMAN Manager / Owner 405-227-1280 |
Organization Subpart ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
Enumeration Date | 2021-09-20 |
Last Update Date | 2024-04-25 |