| NPI | 1922572809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW JOSEPH COMSTOCK Owner/President 918-744-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-01-14 |