| NPI | 1548025596 |
|---|---|
| Doing Business As | PRIMARY CLINIC |
| Entity Type | Organization |
| Authorized Contact | LARRY A MONTGOMERY Owner 918-340-6477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2024-02-19 |
| Last Update Date | 2026-05-05 |