| NPI | 1639515471 |
|---|---|
| Doing Business As | PEDISTAT |
| Entity Type | Organization |
| Authorized Contact | ETHAN AAEON WARLICK President 918-853-1634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: OK 21053) |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2013-05-20 |