| NPI | 1114126331 |
|---|---|
| Doing Business As | EASTSIDE CLINIC |
| Entity Type | Organization |
| Authorized Contact | WENDY S BARTANEN President 580-351-2278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 20119) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2007-07-17 |