| NPI | 1487116612 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY PHILLIPS Director Of Business Affairs 918-893-9240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2019-04-05 |
| Last Update Date | 2023-11-27 |