| 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 |