NPI | 1942919998 |
---|---|
Entity Type | Organization |
Authorized Contact | TIM BALES Authorized Official 405-501-6261 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
Enumeration Date | 2022-11-18 |
Last Update Date | 2022-11-18 |