Organization
MARILYN'S OPTICAL
Active
Other names
None
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARILYN MARIE HENDRICKSON (OWNER)
(918) 456-1133
Entity
Organization
Contact information
Practice address
20242 STICK ROSS MOUNTAIN RD, TAHLEQUAH, OK 74464-7374
(918) 456-1133
Mailing address
20242 STICK ROSS MOUNTAIN RD, TAHLEQUAH, OK 74464-7374
(918) 456-1133
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
081682
OK
Other
Enumeration date
03/05/2008
Last updated
03/05/2008
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