Organization
NR EDMOND LLC
Active
Other names
Nerve Renewal Edmond
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY COIT BALES CEO (CEO)
(405) 953-7221
Entity
Organization
Contact information
Practice address
3520 S BOULEVARD STE 100, EDMOND, OK 73013-5413
(405) 495-7391
(405) 669-3517
Mailing address
3705 NW 63RD ST STE 200, OKLAHOMA CITY, OK 73116-1937
(405) 953-7221
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
11/03/2023
Last updated
03/03/2025
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