Provider First Line Business Practice Location Address:
305 S 5TH
Provider Second Line Business Practice Location Address:
ST. MARY'S HOSPITAL
Provider Business Practice Location Address City Name:
ENID
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-233-6100
Provider Business Practice Location Address Fax Number:
580-249-3982
Provider Enumeration Date:
03/02/2007