| NPI | 1881170520 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARA MARIE BEAIR BUTLER CEO/Owner 918-809-6952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OK 5195) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OK 1172) |
| 208000000X Pediatrics (Licence: OK 5195) | |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-07-16 |