| NPI | 1235677121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA J YOUNG CEO 918-931-7232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2017-02-10 |
| Last Update Date | 2021-06-24 |