| NPI | 1104031996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON MICHAEL LOVE Physician 580-353-5030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 24537) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX K8651) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2008-09-08 |