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Organization

SHEPHERD MALL THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS EDWIN BROWN JR. (PRESIDENT)
(405) 355-3239
Entity
Organization

Contact information

Practice address
2401 NW 23RD ST STE 2D, OKLAHOMA CITY, OK 73107-2420
(405) 355-3239
(405) 212-4270
Mailing address
4334 NW EXPRESSWAY STE 187, OKLAHOMA CITY, OK 73116-1515
(405) 212-4270

Taxonomy

Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
261QP2000X
Physical Therapy Clinic/Center
Primary
261QX0100X
Occupational Medicine Clinic/Center

Other

Enumeration date
03/07/2018
Last updated
03/07/2018
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