| NPI | 1568946846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETTY MOON Practice Administrator 405-605-8280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2018-09-21 |
| Last Update Date | 2018-09-21 |