Organization
NR MIDWEST CITY LLC
Active
Other names
NERVE RENEWAL MIDWEST CITY
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY COIT BALES CEO (CEO)
(405) 953-7221
Entity
Organization
Contact information
Practice address
8121 NATIONAL AVE STE 105, MIDWEST CITY, OK 73110-7570
(405) 694-4042
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
03/21/2023
Last updated
03/03/2025
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