| NPI | 1568701332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN BLAYLOCK CEO 405-990-0564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OK 15252) |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207T00000X Neurological Surgery | |
| Enumeration Date | 2013-02-13 |
| Last Update Date | 2026-04-27 |