| NPI | 1467182741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN ELAINE GRAHAM Provider 918-319-5021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-06-10 |
| Last Update Date | 2022-10-31 |