Organization
ALLERGY & RESPIRATORY CLINIC OF SOUTHERN OK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN P BONILLA ARNP (OWNER)
(405) 485-9588
Entity
Organization
Contact information
Practice address
821 E VETERANS MEMORIAL HWY, BLANCHARD, OK 73010-9215
(405) 485-9588
(405) 485-3499
Mailing address
PO BOX 1126, NORMAN, OK 73070-1126
(405) 485-9588
(405) 485-3499
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2011
Last updated
10/04/2011
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