| NPI | 1932879699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY DILL Office Administrator 405-735-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-10-29 |