Organization
OM TAHLEQUAH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID E EDWARDS (OWNER/PRESIDENT)
(918) 682-1616
Entity
Organization
Contact information
Practice address
3101 CHANDLER RD, SUITE 105, MUSKOGEE, OK 74403-4954
(918) 682-1616
(918) 687-4448
Mailing address
3101 CHANDLER RD, SUITE 105, MUSKOGEE, OK 74403-4954
(918) 682-1616
(918) 687-4448
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
OK
Other
Enumeration date
08/20/2006
Last updated
07/21/2022
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