| NPI | 1598512709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW CRAWFORD CLARK CEO 918-699-4250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Enumeration Date | 2024-05-04 |
| Last Update Date | 2024-10-07 |