| NPI | 1578194221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE S MASSENGILL CEO 405-990-5967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-11-22 |