NPI | 1396012407 |
---|---|
Entity Type | Organization |
Authorized Contact | LYNN KARIN JENNINGS Medical Director 918-493-1011 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OK 18381) |
Enumeration Date | 2011-11-18 |
Last Update Date | 2011-11-18 |