| Osu-aj Ent Of Oklahoma | |
|
5402 Sw Lee Blvd Lawton OK 73505-9521 | |
| (918) 561-8306 | |
| (918) 561-5747 |
| Full Name | Osu-aj Ent Of Oklahoma |
|---|---|
| Speciality | Clinic/center |
| Location | 5402 Sw Lee Blvd, Lawton, Oklahoma |
| Authorized Official Name and Position | Eric Polak (VICE PRESIDENT FOR ADMIN/FINANCE) |
| Authorized Official Contact | 9185618422 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Osu-aj Ent Of Oklahoma 2345 Southwest Blvd Tulsa OK 74107-2705 Ph: (918) 561-8306 | Osu-aj Ent Of Oklahoma 5402 Sw Lee Blvd Lawton OK 73505-9521 Ph: (918) 561-8306 |
| NPI Number | 1487106670 |
|---|---|
| Provider Enumeration Date | 11/04/2016 |
| Last Update Date | 11/04/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487106670 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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