Organization
VASCULAR DISEASE LABORATORY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH MULLINS (OWNER)
(405) 330-5755
Entity
Organization
Contact information
Practice address
2000 E 15TH ST, STE. 300B, EDMOND, OK 73013-6697
(405) 330-5755
Mailing address
2000 E 15TH ST, STE. 300B, EDMOND, OK 73013-6697
(405) 330-5755
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
OK
Other
Enumeration date
08/17/2006
Last updated
08/22/2020
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