| NPI | 1659621811 |
|---|---|
| Doing Business As | 580 SPORTS MEDICINE |
| Entity Type | Organization |
| Authorized Contact | BETTI R ESTEP Credentialing/Billing Mgr 405-521-1969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: OK 4081) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2016-12-13 |