Organization
OKLAHOMA ALLERGY & ASTHMA CLINIC LAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE LYNN KOUGH (BUSINESS OFFICE MANAGER)
(405) 235-0040
Entity
Organization
Contact information
Practice address
750 NE 13TH ST, OKLAHOMA CITY, OK 73104-5051
(405) 235-0040
(405) 235-4495
Mailing address
PO BOX 26827, OKLAHOMA CITY, OK 73126-0827
(405) 235-0040
(405) 235-4495
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
OK
Other
Enumeration date
11/03/2006
Last updated
08/22/2020
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