| NPI | 1720417546 |
|---|---|
| Doing Business As | OSU MEDICAL GROUP RIVERSIDE PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | ERIC POLAK CFO 918-561-8422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2013-11-02 |