Provider First Line Business Practice Location Address:
940 NE 14TH STREET, SUITE 2G-2300
Provider Second Line Business Practice Location Address:
PEDIATRIC EMERGENCY MEDICINE OFFICE
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73104
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-271-2429
Provider Business Practice Location Address Fax Number:
405-271-2421
Provider Enumeration Date:
05/21/2009