| NPI | 1770881021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUFUNSHO OLADIPO BANKOLE Manager/Owner 806-290-0485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 58391) |
| Enumeration Date | 2011-03-10 |
| Last Update Date | 2011-03-10 |