| NPI | 1235727397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLEY MITCHELL Billing Specialist 918-809-4194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2021-01-05 |