| Ketamine Ok Llc | |
|
1105 Sw 30th Ct Moore OK 73160-2887 | |
| (405) 703-0937 | |
| (405) 378-2776 |
| Full Name | Ketamine Ok Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1105 Sw 30th Ct, Moore, Oklahoma |
| Authorized Official Name and Position | Julie Dudley (PRACTICE MANAGER) |
| Authorized Official Contact | 4057030937 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ketamine Ok Llc 1105 Sw 30th Ct Moore OK 73160-2887 Ph: (405) 703-0937 | Ketamine Ok Llc 1105 Sw 30th Ct Moore OK 73160-2887 Ph: (405) 703-0937 |
| NPI Number | 1649738865 |
|---|---|
| Provider Enumeration Date | 03/06/2019 |
| Last Update Date | 03/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649738865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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