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Organization
OKLAHOMA PAIN & REHAB LLC
Active
Organization
OKLAHOMA PAIN & REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM RYAN (OWNER)
(405) 926-7926
Entity
Organization
Contact information
Practice address
2121 S COLUMBIA AVE, SUITE 501, TULSA, OK 74114-3505
(918) 747-0716
Mailing address
2121 S COLUMBIA AVE, SUITE 501, TULSA, OK 74114-3505
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
NULL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
04/18/2011
Last updated
06/13/2012
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