| NPI | 1245060854 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREY MARLER Manager 918-888-8080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-07 |