| NPI | 1104816826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH ANN COFFMAN Half Owner Of Clinic Member P LLC 918-622-1242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2008-04-20 |