| NPI | 1083049001 |
|---|---|
| Doing Business As | OSU-AJ INTEGRIS GRAND LAKE ENT |
| Entity Type | Organization |
| Authorized Contact | ERIC POLAK CFO Osu Physicians 918-561-8422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2016-08-20 |