Organization
OKLAHOMA LIMB & BRACE CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD LOUIS HERONEME SR. CP (OWNER)
(918) 426-4424
Entity
Organization
Contact information
Practice address
1023 S 2ND ST, MCALESTER, OK 74501-6401
(918) 426-4424
(918) 426-4460
Mailing address
125 S MAIN ST # 346, MCALESTER, OK 74501-5363
(918) 426-4424
(918) 426-4460
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100812800A
—
OK
Enumeration date
03/23/2007
Last updated
10/20/2009
Update your record
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