| NPI | 1457377822 |
|---|---|
| Doing Business As | MAIN STREET FAMILY MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | DAVID BLACKMON CFO 580-355-8620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 14363) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2008-01-29 |