Organization
TAF ANCILLARY MEDICAL SERVICES CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AILEEN R BURGESS (PRESIDENT)
(918) 214-6699
Entity
Organization
Contact information
Practice address
300 W OSAGE ST, CLEVELAND, OK 74020-4609
(918) 865-7177
(918) 865-7177
Mailing address
RR 1 BOX 469, TERLTON, OK 74081-9738
(918) 865-7177
(918) 865-7177
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
05/31/2008
Last updated
05/31/2008
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