| NPI | 1508096447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA RAGAN Director Of Operations 580-371-9117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2009-11-20 |