| NPI | 1932887767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRANG HUYEN NGUYEN Owner 918-850-4741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2024-02-09 |