| NPI | 1407026990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L. ODOM Chief Executive Officer 405-634-4434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: AZ 218104) |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2016-04-12 |