| NPI | 1528777364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA G BROCK Owner 405-341-0203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2023-06-14 |