| NPI | 1730993460 |
|---|---|
| Other Name | MEDWISE LLC - BROKEN ARROW EAST |
| Entity Type | Organization |
| Authorized Contact | DENNIS SIDNEY BLACKSTAD President 918-605-6582 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2025-02-04 |
| Last Update Date | 2025-02-04 |