| NPI | 1962588855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD JOSEPH LAUDERDALE Owner 580-256-4050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OK PT795) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2020-08-22 |