| NPI | 1235399122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE G SULLIVAN Owner 918-254-6822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: OK 23824) |
| Enumeration Date | 2008-06-13 |
| Last Update Date | 2017-01-10 |