| Northeastern Oklahoma Advanced Neurotherapeutics Llc | |
|
3450 E Frank Phillips Blvd Suite 100 Bartlesville OK 74006-2406 | |
| (918) 338-3781 | |
| (918) 338-3782 |
| Full Name | Northeastern Oklahoma Advanced Neurotherapeutics Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 3450 E Frank Phillips Blvd, Bartlesville, Oklahoma |
| Authorized Official Name and Position | Walter A Lajara-nanson (SOLE MEMBER) |
| Authorized Official Contact | 9183383781 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeastern Oklahoma Advanced Neurotherapeutics Llc 3450 E Frank Phillips Blvd Suite 100 Bartlesville OK 74006-2406 Ph: (918) 338-3781 | Northeastern Oklahoma Advanced Neurotherapeutics Llc 3450 E Frank Phillips Blvd Suite 100 Bartlesville OK 74006-2406 Ph: (918) 338-3781 |
| NPI Number | 1891026902 |
|---|---|
| Provider Enumeration Date | 01/29/2010 |
| Last Update Date | 01/29/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891026902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 25610 (Oklahoma) | Primary |
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