Provider First Line Business Practice Location Address:
10444 GREENBRIAR PLACE, SUITE C
Provider Second Line Business Practice Location Address:
EBENEZER HEALTH CARE SERVICES, PC
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73159-7660
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-378-2119
Provider Business Practice Location Address Fax Number:
405-759-7022
Provider Enumeration Date:
07/04/2006