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Organization
BOULEVARD FAMILY CLINIC LLC
Active
Organization
BOULEVARD FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
T DENISE CATO (ADMINISTRATOR)
(405) 470-1884
Entity
Organization
Contact information
Practice address
3431 S BOULEVARD, SUITE 109, EDMOND, OK 73013-5475
(405) 470-1884
Mailing address
3431 S BOULEVARD, SUITE 109, EDMOND, OK 73013-5475
(405) 470-1884
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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