Organization
CORAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY SMITH (CEO)
(718) 875-4454
Entity
Organization
Contact information
Practice address
12352 MARKET DR, OKLAHOMA CITY, OK 73114-8136
(718) 875-4454
Mailing address
12352 MARKET DR, OKLAHOMA CITY, OK 73114-8136
(718) 875-4454
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/10/2020
Last updated
08/10/2020
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