| NPI | 1972750941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY S HALSELL Provider/Physician 918-728-8020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2015-11-21 |