| NPI | 1699390963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT A KREITZBERG Do/Owner 918-940-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2020-06-12 |
| Last Update Date | 2021-07-13 |