| NPI | 1487341517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BENDER Director, Product & Data Management 918-779-7475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2023-04-19 |