NPI | 1871733519 |
---|---|
Entity Type | Organization |
Authorized Contact | MARTHA JEAN ROOT Owner 918-260-8802 |
Organization Subpart ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: OK 2299) |
Enumeration Date | 2009-02-20 |
Last Update Date | 2009-02-20 |