Organization
JILLIAN RILEY D.O. P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JILLIAN R RILEY D.O. (OWNER)
(918) 406-2567
Entity
Organization
Contact information
Practice address
1202 W CHEROKEE ST, SUITE D, WAGONER, OK 74467-4629
(918) 406-2567
(918) 742-1103
Mailing address
1202 W CHEROKEE ST, SUITE D, WAGONER, OK 74467-4629
(918) 406-2567
(918) 742-1103
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
4553
OK
Other
Enumeration date
01/15/2009
Last updated
06/11/2009
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