NPI | 1417789272 |
---|---|
Entity Type | Organization |
Authorized Contact | MATTHEW ALLEN LAWRENCE Owner 918-809-6133 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 208D00000X General Practice |
Enumeration Date | 2024-08-19 |
Last Update Date | 2024-10-11 |