| NPI | 1598480220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM BALES Authorized Official 405-495-7391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2022-10-05 |
| Last Update Date | 2022-10-05 |