| NPI | 1114283025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD FERGUSON CEO 918-477-5049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2012-06-19 |