| NPI | 1609995141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACLYN ANNE HAYNIE Chief Administrative Officer 405-613-4354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2025-08-15 |