| NPI | 1508609835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER FISHER Owner 918-417-0878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2024-06-14 |
| Last Update Date | 2024-06-14 |