| NPI | 1891040887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA KYLE Clinical Director 405-525-0452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OK 448885159) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2012-07-17 |