| NPI | 1669663332 |
|---|---|
| Doing Business As | HERITAGE MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | DAVID ALAN TRAUB President/Owner 918-494-9994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |