| NPI | 1700534252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILSON GREGORY KNIGHT Owner 918-712-0239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| 207QS0010X Family Medicine, Sports Medicine | |
| Enumeration Date | 2022-03-14 |
| Last Update Date | 2022-08-15 |