| Healthy Life Pllc | |
|
800 W Boise Cir Suite 290 Broken Arrow OK 74012-4906 | |
| (918) 344-9368 | |
| Not Available |
| Full Name | Healthy Life Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 800 W Boise Cir, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Roberta Rau (PRESIDENT/OWNER) |
| Authorized Official Contact | 9183449368 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Life Pllc 800 W Boise Cir Suite 290 Broken Arrow OK 74012-4906 Ph: (918) 344-9368 | Healthy Life Pllc 800 W Boise Cir Suite 290 Broken Arrow OK 74012-4906 Ph: (918) 344-9368 |
| NPI Number | 1700120458 |
|---|---|
| Provider Enumeration Date | 11/19/2012 |
| Last Update Date | 11/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700120458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 21264 (Oklahoma) | Primary |
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