Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2006-05-27
- Last updated
- 2011-11-04
Specialties
Licenses
- License OK
- 7110
Location
- Practice location
- 217 S. GRAND
- City
- CHEROKEE OK
- Postal code
- 737280186
- Phone
- 580-596-3535
Organization contact
- Name
- LYNETTE MORRIS
- Title
- Owner/Administrator
- Phone
- 5805963535
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.