Organization
MIRAWORX OF OKC 1 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROLYN CUMMINS DAVIES CPA (CONSULTANT)
(918) 286-7347
Entity
Organization
Contact information
Practice address
10400 VINEYARD BLVD APT A, OKLAHOMA CITY, OK 73120-3830
(405) 230-1102
Mailing address
10400 VINEYARD BLVD APT A, OKLAHOMA CITY, OK 73120-3830
(405) 230-1102
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
12/29/2009
Last updated
12/29/2009
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