| NPI | 1053641803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN CUMMINS DAVIES Consultant 918-286-7347 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Enumeration Date | 2009-12-29 |
| Last Update Date | 2009-12-29 |