| Lifelong Wellness Center Inc | |
|
1203 E Ross Byp Ste C Tahlequah OK 74464-4188 | |
| (918) 458-0700 | |
| (918) 458-0424 |
| Full Name | Lifelong Wellness Center Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1203 E Ross Byp Ste C, Tahlequah, Oklahoma |
| Authorized Official Name and Position | Edith-elaine Hamill Hodson (PRESIDENT) |
| Authorized Official Contact | 9184538550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifelong Wellness Center Inc 1203 E Ross Bypass C Tahlequah OK 74464-4188 Ph: (918) 453-8550 | Lifelong Wellness Center Inc 1203 E Ross Byp Ste C Tahlequah OK 74464-4188 Ph: (918) 458-0700 |
| NPI Number | 1043413487 |
|---|---|
| Provider Enumeration Date | 06/05/2007 |
| Last Update Date | 10/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043413487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Oklahoma) | Primary |
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