Organization
CARDIOVASCULAR PERFUSION ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES DEWAYNE POOR (PRESIDENT)
(405) 604-5613
Entity
Organization
Contact information
Practice address
3601 N MAY AVE, STE C, OKLAHOMA CITY, OK 73112-6641
(405) 604-5613
(405) 601-3750
Mailing address
PO BOX 12815, OKLAHOMA CITY, OK 73157-2815
(405) 604-5613
(405) 601-3750
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
LP24
OK
Other
Enumeration date
03/28/2007
Last updated
08/22/2020
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