| NPI | 1811459191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW O'BANNON Manager 405-315-7029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-04-04 |
| Last Update Date | 2019-04-08 |