| NPI | 1326213885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE L BURTON Owner 580-536-2662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OK 4098) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2015-04-03 |