NPI | 1780949313 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIAN ANTHONY WOODARD Manager/ Co Owner 918-425-1385 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: OK 21966) |
Enumeration Date | 2012-07-10 |
Last Update Date | 2012-07-10 |