Organization
NR STILLWATER LLC
Active
Other names
NERVE RENEWAL STILLWATER
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY C BALES (OWNER/CEO)
(405) 953-7221
Entity
Organization
Contact information
Practice address
1411 W 12TH AVE STE D, STILLWATER, OK 74074-5482
(405) 724-6902
(405) 669-3517
Mailing address
3705 NW 63RD ST STE 200, OKLAHOMA CITY, OK 73116-1937
(405) 953-7221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
06/03/2024
Last updated
03/03/2025
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