| NPI | 1750556536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIMMY DEAN SWAN Owner 405-720-2828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OK 5498) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |