Organization
COMANCHE COUNTY HEALTHCARE
Active
Other names
MEMORIAL MEDICAL GROUP PHYSICAL MEDICINE & REHABILITATION
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT SMITH (CFO)
(580) 355-8620
Entity
Organization
Contact information
Practice address
3201 W GORE BLVD, STE 104, LAWTON, OK 73505-6378
(580) 250-6659
(580) 250-5249
Mailing address
PO BOX 785, LAWTON, OK 73502
(580) 357-9984
(580) 357-3277
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4083
OK
Other
Enumeration date
07/20/2006
Last updated
05/08/2015
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