| NPI | 1114736048 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BENDER Sr. Director Data & Analytics 918-779-7475 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2025-01-06 |
| Last Update Date | 2025-01-06 |