| NPI | 1902020753 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET A THOMAS Clinic Administrator 918-428-5373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology |
| 225100000X Physical Therapist | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |