| NPI | 1942659982 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN HARGROVE Sole Member 405-513-8326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-13 |