| NPI | 1427279561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY G PETTINGELL Physician 918-252-7952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |