| Organization Name: | SKIATOOK OSTEOPATHIC CLINIC, INC |
| NPI Number: | 1609081538 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUDOLPH JOSEPH WOLF (PRESIDENT) |
| Mailing Address: | 201 E 2nd St Pob 428 Skiatook |
| State: | OK US |
| Postal Code: | 740701211 |
| Phone Number: | 9183961262 |
| Fax Number: | 9183964598 |
| NPI Enumeration Date: | 05/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |