| NPI | 1447878269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREY MARLER Manager 918-879-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Enumeration Date | 2020-07-08 |
| Last Update Date | 2024-07-17 |