| NPI | 1396881959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN DONNELL Physiian 405-348-6621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OK 363A00000X) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |