Provider First Line Business Practice Location Address: 
MCBRIDE CLINIC, INC.
    Provider Second Line Business Practice Location Address: 
1110 N LEE
    Provider Business Practice Location Address City Name: 
OKLAHOMA CITY
    Provider Business Practice Location Address State Name: 
OK
    Provider Business Practice Location Address Postal Code: 
73103
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
405-230-9000
    Provider Business Practice Location Address Fax Number: 
405-230-9421
    Provider Enumeration Date: 
06/01/2007