| NPI | 1558816850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE CLARK COO 405-768-5749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OK 26716) |
| Enumeration Date | 2016-08-17 |
| Last Update Date | 2025-02-18 |