Organization
SOUTHERN OKLAHOMA LIFESTYLES AND PREVENTATIVE MEDICINE
Active
Parent organization
PARADIGM HORMONES, PLLC
Other names
Paradigm Hormones
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARADIGM HORMONES, PLLC
Authorized official
NIKKI BUSELLATO (INS. CREDENTIALING)
(405) 703-3614
Entity
Organization
Contact information
Practice address
731 12TH AVE NW STE 201, ARDMORE, OK 73401-5764
(405) 703-3614
Mailing address
1301 S I 35 SERVICE RD STE 106, MOORE, OK 73160-3187
(405) 703-3614
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
OK
Other
Enumeration date
11/17/2017
Last updated
11/17/2017
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