| NPI | 1093039984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA G OWENS Coder/Biller 918-302-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: OK Roo73757) |
| Enumeration Date | 2010-03-21 |
| Last Update Date | 2013-06-07 |