NPI | 1588141170 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES AARON HENLEY Owner 918-409-3497 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 208000000X Pediatrics (Licence: OK 4195) |
Enumeration Date | 2018-07-26 |
Last Update Date | 2024-04-17 |