Organization
RESTORE AND MORE INC
Active
Other names
Restore and More Master Clinicians
Organization subpart
No
Provider details
NPI number
Authorized official
DALA R JAROLIM MD (VICE PRESIDENT)
(918) 695-6673
Entity
Organization
Contact information
Practice address
1217 W MAIN ST, JENKS, OK 74037-2311
(918) 695-6673
(918) 747-6673
Mailing address
1217 W MAIN ST, JENKS, OK 74037-2311
(918) 695-6673
(918) 747-6673
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2064
OK
207R00000X
Internal Medicine Physician
Primary
11015
OK
207RX0202X
Medical Oncology Physician
68501
PA
Other
Enumeration date
10/18/2011
Last updated
10/18/2011
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