Provider First Line Business Practice Location Address:
6262 S SHERIDAN RD
Provider Second Line Business Practice Location Address:
SHADOW MOUNTAIN BEHAVIORAL HEALTH
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74133
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-493-3208
Provider Business Practice Location Address Fax Number:
918-497-4952
Provider Enumeration Date:
03/28/2006