| NPI | 1407977366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN WISEMAN Owner 918-299-8232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2020-08-22 |