| NPI | 1710640255 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES LINN Authorized Official 918-398-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-10-21 |
| Last Update Date | 2021-10-21 |