Organization
LIFELONG WELLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDITH-ELAINE HAMILL HODSON (PRESIDENT)
(918) 453-8550
Entity
Organization
Contact information
Practice address
1203 E ROSS BYP STE C, TAHLEQUAH, OK 74464-4188
(918) 458-0700
(918) 458-0424
Mailing address
1203 E ROSS BYPASS, C, TAHLEQUAH, OK 74464-4188
(918) 453-8550
(918) 456-1096
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
OK
Other
Enumeration date
06/05/2007
Last updated
10/18/2007
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