Organization
PROVECTUS DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN T MCCORMACK (OWNER/CEO)
(626) 244-8200
Entity
Organization
Contact information
Practice address
4150 S 100TH EAST AVE, SUITE 105, TULSA, OK 74146-3650
(918) 949-4526
(918) 949-4549
Mailing address
4150 S 100TH EAST AVE, SUITE 105, TULSA, OK 74146-3650
(918) 949-4526
(918) 949-4549
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
OK
Other
Enumeration date
04/16/2015
Last updated
10/29/2024
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