| NPI | 1972735959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA ALWORTH Owner 580-222-6935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: OK 4723) |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2009-12-21 |