| NPI | 1851936611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA EMMA GREENE Credentialing Manager 918-899-7375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0100X Clinic/Center, Occupational Medicine |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2019-11-14 |
| Last Update Date | 2020-02-03 |