| NPI | 1902622293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY BENDER Sr. Director, Data & Analytics 918-779-7475 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2024-12-02 |
| Last Update Date | 2024-12-02 |