| Premier Physical Medicine Llc | |
|
3011 N Union St Ponca City OK 74601-7400 | |
| (316) 683-9500 | |
| (316) 683-9502 |
| Full Name | Premier Physical Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3011 N Union St, Ponca City, Oklahoma |
| Authorized Official Name and Position | Tanner P Hancock (OWNER) |
| Authorized Official Contact | 3166839500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Physical Medicine Llc 6224 Shadybrook St Wichita KS 67208-1844 Ph: (316) 683-9500 | Premier Physical Medicine Llc 3011 N Union St Ponca City OK 74601-7400 Ph: (316) 683-9500 |
| NPI Number | 1710229836 |
|---|---|
| Provider Enumeration Date | 03/27/2013 |
| Last Update Date | 03/27/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710229836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Kansas) | Primary |
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