Organization
REGENMEDOK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M BRISCOE (MANAGER)
(918) 921-7661
Entity
Organization
Contact information
Practice address
1150 E LANSING ST, BROKEN ARROW, OK 74012-2429
(918) 921-7661
(918) 921-7662
Mailing address
1150 E LANSING ST, BROKEN ARROW, OK 74012-2429
(918) 921-7661
(918) 921-7662
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
08/19/2020
Last updated
08/20/2020
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