| NPI | 1255671806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH WEESNER Owner 580-332-7337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OK 16267) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OK 0065815) |
| Enumeration Date | 2013-02-19 |
| Last Update Date | 2013-02-19 |