| NPI | 1528364304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTI R ESTEP Billing/Credentialing Mgr 405-521-1969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OK 9074) |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2015-04-23 |