| NPI | 1902106586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD L. NICHOLS Vice President 405-601-0954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OK PA03727) |
| Enumeration Date | 2010-10-28 |
| Last Update Date | 2010-10-28 |