| NPI | 1245093699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA SCHIESEL Primary Owner/Medical Director 918-200-5454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2024-01-30 |