| NPI | 1942376454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA DENISE SHEHAN Vice President Owner 918-660-0031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK 10210) |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2020-08-22 |