Organization
PEORIA MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAN RILEY D.C. (OWNER)
(918) 743-3737
Entity
Organization
Contact information
Practice address
3345 S HARVARD AVE, STE #101, TULSA, OK 74135-1812
(918) 743-3737
(918) 743-8383
Mailing address
3345 S HARVARD AVE, STE #101, TULSA, OK 74135-1812
(918) 743-3737
(918) 743-8383
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
3542
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992897920
NPI
OK
Enumeration date
09/13/2007
Last updated
09/13/2007
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