| NPI | 1124672811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN L TWYMAN Manager 918-853-9407 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2021-03-16 |