| NPI | 1275783623 |
|---|---|
| Doing Business As | SOUTHWEST OKLAHOMA SPORTS & INTERNAL MEDICINE |
| Entity Type | Organization |
| Authorized Contact | DANIEL CONSTANCE Member 580-536-1111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2009-01-16 |