Provider First Line Business Practice Location Address:
13900 N. PORTLAND AVE. SUITE 100
Provider Second Line Business Practice Location Address:
ADVANCCED BODY SCAN
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73134-4042
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-242-1390
Provider Business Practice Location Address Fax Number:
405-242-1400
Provider Enumeration Date:
12/15/2011