| NPI | 1699935676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY J CONNAUGHTON Office Manager 918-665-2676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OK 3933) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2011-02-16 |