| NPI | 1871092494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOREN QUIRAM Director Of Quality Management 918-287-5123 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QR1300X Clinic/Center, Rural Health | |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2020-06-01 |