NPI | 1205105780 |
---|---|
Entity Type | Organization |
Authorized Contact | CAROLANNE HOPE ROACH President 405-703-3163 |
Organization Subpart ? | No |
Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: OK 2581) |
Enumeration Date | 2011-12-29 |
Last Update Date | 2024-12-05 |