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Organization
NR SOUTHWEST OKC LLC
Active
Organization
NR SOUTHWEST OKC LLC
Active
Other names
Nerve Renewal Southwest, Nerve Renewal SW OKC
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY C BALES OWNER/CEO (AUTHORIZED OFFICIAL)
(405) 953-7221
Entity
Organization
Contact information
Practice address
9821 S MAY AVE STE B, OKLAHOMA CITY, OK 73159-7042
(405) 495-7391
Mailing address
3705 NW 63RD ST STE 200, OKLAHOMA CITY, OK 73116-1937
(405) 953-7221
(405) 669-3517
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/05/2022
Last updated
08/13/2026
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