| NPI | 1043210305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF SMITH Administrator 918-494-9313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| 225100000X Physical Therapist | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2009-04-01 |