Organization
PARADIGM HORMONES -EDMOND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKKI BUSELLATO (INS.CREDENTIALING)
(405) 703-3614
Entity
Organization
Contact information
Practice address
1301 S I 35 SERVICE RD, STE 106, MOORE, OK 73160-3182
(405) 703-3614
(405) 703-7021
Mailing address
13100 N WESTERN AVE, OKLAHOMA CITY, OK 73114-1430
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
OK
Other
Enumeration date
04/21/2017
Last updated
04/21/2017
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