| NPI | 1669870507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY CHRISTINE FOOTE President 405-795-8291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NJ 25MB09608600) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 272882-1) |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2014-12-09 |