| NPI | 1669505616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BLAKE WILSON Owner 405-741-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: OK 1-3041) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2021-01-08 |