| NPI | 1205591708 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LEE ROADHOUSE Owner/President 918-481-2772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207L00000X Anesthesiology | |
| 261QP2000X Clinic/Center Physical Therapy | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2021-11-01 |
| Last Update Date | 2025-05-08 |