| NPI | 1396274809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON HART Clinical Director 405-928-4229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2305) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2017-06-08 |