| NPI | 1922081959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID R. LONG Administrator CEO 918-481-7644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site (Licence: OK 18573) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2011-10-15 |