| NPI | 1609061332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA KEITH President 918-585-3045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: OK 611) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2012-02-10 |