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 |