| NPI | 1639621246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH GUCWA Dir Of Facilities And Purchasing 918-779-7416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2016-10-30 |
| Last Update Date | 2016-10-30 |