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Organization
OKLAHOMA STATE UNIVERSITY
Active
Organization
OKLAHOMA STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KYLA WITTNER (RN)
(918) 440-0005
Entity
Organization
Contact information
Practice address
744 W 9TH ST, TULSA, OK 74127-9020
(918) 599-1000
Mailing address
102 E BRAHMA AVE, DEWEY, OK 74029-2712
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
0106977
OK
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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