Organization
EDEN DIAGNOSTIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM ANGEL (OFFICE MANAGER)
(918) 508-7008
Entity
Organization
Contact information
Practice address
5906 E 31ST ST, TULSA, OK 74135-5110
(918) 508-7008
Mailing address
5906 E 31ST ST, TULSA, OK 74135-5110
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1709
OK
Other
Enumeration date
09/01/2016
Last updated
07/13/2017
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