| NPI | 1922300789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLE M VROOME Owner 918-742-7361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: OK 55967) |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2010-11-30 |