| NPI | 1922483627 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEVI TAYLOR KEEHLER Owner 918-901-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: OK 3992) |
| Additional Taxonomies | 251S00000X (Licence: OK 606) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2024-01-04 |