| NPI | 1972544807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUS D CANADAY President/Owner 918-437-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OK R0067546) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2010-06-15 |