| NPI | 1609135888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA KEOUGH Credentialing Specialist 405-848-7974 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: NY 239194) |
| Enumeration Date | 2012-05-09 |
| Last Update Date | 2012-05-09 |