| NPI | 1265627087 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BERDECIA Medical Director/Owner 580-256-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OK 25220) |
| Enumeration Date | 2007-09-14 |
| Last Update Date | 2007-09-14 |