Provider First Line Business Practice Location Address:
3300 NW EXPRESSWAY
Provider Second Line Business Practice Location Address:
INTEGRIS-BAPTIST MEDICAL CENTER
Provider Business Practice Location Address City Name:
OKC
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73112-4481
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-949-3544
Provider Business Practice Location Address Fax Number:
405-951-9954
Provider Enumeration Date:
09/05/2012