Organization
LEGACY THERAPEUTIC SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT CORNELIUS (CEO)
(405) 822-8458
Entity
Organization
Contact information
Practice address
310 12TH AVE NE, NORMAN, OK 73071-5238
(405) 822-8458
Mailing address
PO BOX 278, BIXBY, OK 74008-0278
(405) 822-8458
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Enumeration date
04/02/2025
Last updated
04/02/2025
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