| NPI | 1962861625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT KEITH HOLLIMAN Auth Official 405-285-2994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2024-04-25 |