Organization
AMATTCO LLC
Active
Parent organization
AMATTCO LLC
Other names
New Leaf Wellness Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMATTCO LLC
Authorized official
DR. DAVID RYKER SR. MD (SUPERVISING PHYSICAN)
(405) 751-9800
Entity
Organization
Contact information
Practice address
3100 S ELM PL, SUITE B, BROKEN ARROW, OK 74012-7950
(918) 884-7800
(918) 731-4518
Mailing address
3705 WEST MEMORIAL RD, SUITE 601, OKLAHOMA CITY, OK 73134-1512
(405) 751-9800
(405) 751-9808
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
73548
OK
174400000X
Specialist
9365
OK
363L00000X
Nurse Practitioner
79139
OK
363L00000X
Nurse Practitioner
86262
OK
363L00000X
Nurse Practitioner
R0078723
OK
Other
Enumeration date
08/31/2016
Last updated
08/31/2016
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