Provider First Line Business Practice Location Address:
6565 S YALE AVE STE 410
Provider Second Line Business Practice Location Address:
TULSA MEDICAL LAB, KELLY PROFESSIONAL BLDG.
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74136-8305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-481-7844
Provider Business Practice Location Address Fax Number:
918-481-7852
Provider Enumeration Date:
07/24/2007