| NPI | 1942703665 |
|---|---|
| Other Name | NORTHEAST OKLAHOMA SPINE AND SPORTS |
| Entity Type | Organization |
| Authorized Contact | MARK BILLY WILLITS Owner 918-518-5013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2018-03-09 |