| NPI | 1871843920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN BAKER FORE Doctor 580-223-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 207K00000X Allergy & Immunology |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2015-02-13 |