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OKLAHOMA CITY, OK
NPI1578881207
Entity TypeOrganization
Authorized ContactKIMBERLY SHOALS
Clinical Director
405-272-1610
Organization Subpart ?No
Primary Taxonomy251S00000X 
Enumeration Date2010-05-05
Last Update Date2010-05-05
Business Address
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214 SW 30TH ST
OKLAHOMA CITY, OK 73109-6506
Phone number: 405-272-1610
Mailing Address
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214 SW 30TH ST
OKLAHOMA CITY, OK 73109-6506
Phone number: 405-272-1610
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