| NPI | 1760912075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE JONES Executive Sensei 918-982-8333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207T00000X Neurological Surgery | |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2019-09-09 |