Organization
MATRIX NETWORK MANAGEMENT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS FONDREN (MANAGING DIRECTOR)
(405) 600-1290
Entity
Organization
Contact information
Practice address
409 E CALIFORNIA AVE STE 210, OKLAHOMA CITY, OK 73104-4226
(405) 600-1290
Mailing address
409 E CALIFORNIA AVE STE 210, OKLAHOMA CITY, OK 73104-4226
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
08/19/2009
Last updated
08/19/2009
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