| NPI | 1861888083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN EDWARD FELL Manager 918-864-0660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OK 3804) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2015-04-14 |