| NPI | 1750662169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACK WALKER Owner 405-513-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: OK R0058479) |
| Enumeration Date | 2011-08-31 |
| Last Update Date | 2013-07-03 |