| NPI | 1881270114 |
|---|---|
| Doing Business As | SSM HEALTH MEDICAL GROUP HEALTHY LIVING |
| Entity Type | Organization |
| Authorized Contact | CRYSTAL L PENA Provider Enrollment 405-272-7452 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2021-03-18 |