| NPI | 1144643024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERI L MOORE Credentialing COO Rdinator 405-775-9350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: OK 5059) |
| Enumeration Date | 2014-01-28 |
| Last Update Date | 2014-01-28 |