Organization
SOUTHEASTERN OKLAHOMA FOOT TECHNOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DENISIA LEE DERAMUS CPED (OWNER / CPED)
(918) 567-7000
Entity
Organization
Contact information
Practice address
1 CHOCTAW WAY, TALIHINA, OK 74571-2022
(918) 567-7000
Mailing address
PO BOX 897, TALIHINA, OK 74571-0897
(918) 567-7000
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
154
OK
Other
Enumeration date
10/27/2016
Last updated
10/27/2016
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