| NPI | 1104294818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLA WITTNER RN 918-440-0005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OK 0106977) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2015-09-11 |