| NPI | 1073164125 |
|---|---|
| Doing Business As | TAHLEQUAH ENT |
| Entity Type | Organization |
| Authorized Contact | SCOTT ROSENTHAL CEO 918-772-3390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2020-06-09 |