Provider First Line Business Practice Location Address:
4502 E. 41ST STREET, 2G08
Provider Second Line Business Practice Location Address:
OU PHYSICIANS TULSA-CLINICAL SERVICES
Provider Business Practice Location Address City Name:
TULSA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74134-2553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-660-3632
Provider Business Practice Location Address Fax Number:
918-660-3631
Provider Enumeration Date:
07/28/2006