| NPI | 1215520218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE REBENITSCH Surgeon 405-733-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center Ophthalmologic Surgery |
| Enumeration Date | 2021-02-19 |
| Last Update Date | 2021-02-19 |