Organization
ORTHO PLUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT KEITH HOLLIMAN PA (AUTHORIZED OFFICIAL)
(405) 227-1280
Entity
Organization
Contact information
Practice address
2419 N COMMERCE ST STE B, ARDMORE, OK 73401-1357
(580) 226-7587
(580) 226-4878
Mailing address
301 LILAC DR STE 140, EDMOND, OK 73034-7288
(405) 906-3375
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
09/20/2021
Last updated
01/20/2025
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