| NPI | 1255829149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCARLETT NICOLE VIRDEN Owner Operator 918-397-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 93576) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2024-02-01 |