| NPI | 1033106448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT VAN BLAKEBURN President/Owner 580-323-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 17199) |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2009-08-26 |