| NPI | 1740921014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLIE ELIZABETH SHARROCK Owner 580-245-7044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-04-02 |
| Last Update Date | 2022-09-06 |