| NPI | 1952527178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT GENE KIRK Owner 918-582-6958 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: OK 12982) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |