| NPI | 1053803635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN M FORD Credentialing And Ar Specialist 918-872-8735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OK 2784) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |