| NPI | 1477193316 |
|---|---|
| Doing Business As | GRAND LAKE MEDICAL HEALTH CENTER |
| Entity Type | Organization |
| Authorized Contact | CHARLES DANLEY CEO 918-273-1841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2020-01-08 |