| NPI | 1386947604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE BREWER Director 877-892-9813 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OK 0063) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2011-03-01 |