| NPI | 1194185090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACHORY RANDALL CEO/President 405-607-4041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2021-05-18 |