| NPI | 1770294209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERITA BARRETT Credentialing COO Rdinator 405-600-6869 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2022-12-06 |
| Last Update Date | 2022-12-06 |