| NPI | 1063525954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA LYNN KEITH Clinic Manager 405-348-6611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OK 8699) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2011-05-02 |