| NPI | 1477829554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID PAUL ELLIS Registered Agent 405-232-8003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center Pain (Licence: OK 15874) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2018-07-14 |