| NPI | 1922355023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT SHANE FOSTER Clinic Owner/ Physical Therapist 918-923-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2023-08-10 |