| NPI | 1306317581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA NICOLE DOTY President 405-701-9073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2019-02-20 |