| NPI | 1144882325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAY GREGSTON Owner/Physician 405-608-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2024-06-17 |