| NPI | 1437774874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Insurance Credentialing Specialist 405-272-7452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2020-06-11 |
| Last Update Date | 2020-06-11 |