| NPI | 1083021125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOE MANSOUR Staff Pharmacist 405-361-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: OK 9876) |
| Additional Taxonomies | 261QX0100X Clinic/Center, Occupational Medicine (Licence: TX 23225) |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2014-07-21 |