| NPI | 1649951211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM C COBLE Sole Member/Initial Manager 580-220-7093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2023-07-27 |
| Last Update Date | 2024-01-05 |