is a Specialist in Oklahoma City, Oklahoma. practices all healthcare services and medical treatments related to Specialist. The NPI Number for is 1982655577. The last update date is .
's current location address is 3433 Nw 56th St, Oklahoma City, Oklahoma. You can contact this provider via phone number 4059454701 and fax number 4059454728. The mailing address for is 3433 Nw 56th St, Oklahoma City, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 3433 Nw 56th St, Oklahoma City, Oklahoma |
| Phone Number | 4059454701 |
| Fax Number | 4059454728 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1982655577 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 3433 Nw 56th St |
|---|---|
| City | Oklahoma City |
| State | Oklahoma (OK) |
| Post Code | 731124455 |
| Phone Number | 4059454701 |
| Fax Number | 4059454728 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 17347 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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