Provider First Line Business Practice Location Address:
MFT ARDMORE CLINIC
Provider Second Line Business Practice Location Address:
2510 CHICKASAW BLVD.
Provider Business Practice Location Address City Name:
ARDMORE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-222-2884
Provider Business Practice Location Address Fax Number:
580-564-3605
Provider Enumeration Date:
02/06/2012