Organization
MEDITOX WELLNESS OF OWASSO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY L BOSTIC (OWNER / DIRECTOR)
(918) 671-1148
Entity
Organization
Contact information
Practice address
10314 N 138TH EAST AVE STE 101, OWASSO, OK 74055-4633
(918) 671-1148
(918) 376-4981
Mailing address
10314 N 138TH EAST AVE STE 101, OWASSO, OK 74055-4633
(918) 805-1072
(918) 376-4981
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
06/07/2023
Last updated
06/07/2023
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