| Dallas Restoration Services | |
|
920 S Boulevard Ste 103 Edmond OK 73034-4731 | |
| (405) 406-4803 | |
| Not Available |
| Full Name | Dallas Restoration Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 920 S Boulevard Ste 103, Edmond, Oklahoma |
| Authorized Official Name and Position | Wayne Dallas (CLINICAL DIRECTOR) |
| Authorized Official Contact | 4056772767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dallas Restoration Services 920 S Boulevard Ste 103 Edmond OK 73034-4731 Ph: (405) 406-4803 | Dallas Restoration Services 920 S Boulevard Ste 103 Edmond OK 73034-4731 Ph: (405) 406-4803 |
| NPI Number | 1205198074 |
|---|---|
| Provider Enumeration Date | 06/08/2012 |
| Last Update Date | 06/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205198074 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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