| NPI | 1104856350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRIE G. WILLIAMSON Owner/President 405-701-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OK 2988) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OK 2988) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2010-12-14 |