Organization
SUPPLEMENTAL HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJ WHITLEY (STAFFING MANAGER)
(405) 917-7160
Entity
Organization
Contact information
Practice address
3030 NW EXPRESSWAY, SUITE #809, OKLAHOMA CITY, OK 73112-5474
(405) 917-7160
Mailing address
3030 NW EXPRESSWAY, SUITE #809, OKLAHOMA CITY, OK 73112-5474
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3524
OK
Other
Enumeration date
06/29/2011
Last updated
06/29/2011
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