| NPI | 1326276189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE CAROLE GILLILAND Registered Agent For The LLC 580-591-3817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OK R0027885) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2009-06-30 |