| NPI | 1659337194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFFI MOON COWAN Administrator 580-762-0695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: OK 0021) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2010-11-01 |