NPI | 1407091788 |
---|---|
Entity Type | Organization |
Authorized Contact | BOB ELLIOTT Authorized Representative 405-640-9085 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 2366) |
Enumeration Date | 2008-12-15 |
Last Update Date | 2008-12-15 |