| NPI | 1295163467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER SCOTT WAUGH Manager 405-348-2323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: OK 25617) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2021-09-29 |