| NPI | 1649722851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVE M WILCOX Member 405-936-0504 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-11-04 |