| NPI | 1922029297 |
|---|---|
| Doing Business As | WHITLOCK COSMETIC AND RECONSTRUCTIVE SURGERY |
| Entity Type | Organization |
| Authorized Contact | BRYAN RICHARD WHITLOCK Owner 918-743-5438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: OK OK18447) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-08-22 |