| 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 |