| NPI | 1508063975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNZEE WHITE Medical Assistant 918-299-9779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208600000X Surgery (Licence: OK 3519) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2022-05-24 |