| NPI | 1558603738 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVIN LANE PEYTON Owner 405-753-4994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: OK OK24005) |
| Enumeration Date | 2013-03-26 |
| Last Update Date | 2015-03-05 |