| NPI | 1740947225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S HALSELL Doctor 918-607-6125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2021-11-19 |
| Last Update Date | 2022-10-04 |