Organization
JOE MANSOUR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOE MANSOUR D.PH. (STAFF PHARMACIST)
(405) 361-8080
Entity
Organization
Contact information
Practice address
11805 OLDWICK CIR, OKLAHOMA CITY, OK 73162-3225
(405) 361-8080
Mailing address
11805 OLDWICK CIR, OKLAHOMA CITY, OK 73162-3225
(405) 361-8080
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
9876
OK
261QX0100X
Occupational Medicine Clinic/Center
23225
TX
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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