| NPI | 1619374337 |
|---|---|
| Doing Business As | HIS ARMS EXTENDED |
| Entity Type | Organization |
| Authorized Contact | CHERYL DENISE KITE Reverend 405-505-8329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2014-11-24 |