| NPI | 1417395997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE DAVID MUEGGENBORG Family Nurse Practitioner 405-408-6500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 207Q00000X) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-07-29 |