| NPI | 1730885534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH BADER Manager 918-716-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2024-03-23 |