Organization
CATOOSA HOPE CLINIC PLLC
Active
Other names
Catoosa Hope Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLA LUSSIER M.D. (PHYSICIAN)
(918) 739-4885
Entity
Organization
Contact information
Practice address
1755 N HIGHWAY 66, STE F, CATOOSA, OK 74015-2409
(918) 739-4885
(918) 739-4885
Mailing address
1755 N HIGHWAY 66, STE F, CATOOSA, OK 74015-2409
(918) 739-4885
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200339530A
—
OK
Enumeration date
05/01/2011
Last updated
08/09/2011
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