| NPI | 1346268315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW H ROBERTS Owner 918-540-7655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: OK 223) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 223) |
| 363L00000X Nurse Practitioner (Licence: OK 0058567) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2012-02-16 |