# PREVENTATIVE MEDICAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780908905
- **Authorized official:** AMY GLENN (DIRECTOR OF OPERATIONS)
- **Authorized official phone:** (918) 739-4767

## Contact information

- **Practice address:** 1305 N HIGHWAY 66, SUITE B, CATOOSA, OK 74015-2460
- **Practice address phone:** (918) 955-0224
- **Mailing address:** 1305 N HIGHWAY 66, SUITE B, CATOOSA, OK 74015-2460
- **Mailing address phone:** (918) 955-0224

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/17/2010
- **Last updated:** 01/26/2011