Individual
MERCADES KOLOSHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDMS
Contact information
Practice address
8400 S KALANCHOE AVE, BROKEN ARROW, OK 74011-7810
(918) 574-1134
Mailing address
8400 S. KALANCHOE AVE., BROKEN ARROW, OK 74011
(918) 574-1134
Taxonomy
Speciality
Code
Description
License number
State
261QR0208X
Mobile Radiology Clinic/Center
Primary
—
—
Other
Enumeration date
05/16/2024
Last updated
05/16/2024
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