| NPI | 1124139126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND F SORENSEN Owner 918-496-5195 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OK 1732) |
| Additional Taxonomies | 174400000X Specialist (Licence: OK 1434) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2009-06-25 |