| NPI | 1649870700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM LANCE MADISON Clinical Director 918-642-5492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-28 |