| NPI | 1184235921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD G ALLEN Provider 918-430-9709 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2021-02-17 |