| NPI | 1639966740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYLER RHODES Admin 918-740-3473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 208VP0000X |
| Enumeration Date | 2025-04-22 |
| Last Update Date | 2025-04-24 |