| NPI | 1407553597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTTY EUGENE JACKSON Nurse Practitioner / Owner 405-207-9238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2023-04-20 |