| NPI | 1790103455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE LEIGH ELLIOTT Owner 918-595-2331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OK 140237) |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2014-03-31 |