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Organization
SPECTRA FAMILY MEDICAL CLINIC LLC
Active
Organization
SPECTRA FAMILY MEDICAL CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DAVONDRA LOVE OWENS (CFO)
(405) 733-0120
Entity
Organization
Contact information
Practice address
6520 E RENO, SUITE A, MIDWEST CITY, OK 73110-2109
(405) 733-0120
(405) 733-7876
Mailing address
PO BOX 223, SPENCER, OK 73084-0223
(405) 733-0120
(405) 733-7876
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
8459
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200131340A
—
OK
Enumeration date
02/13/2008
Last updated
03/12/2013
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