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Organization

NEW TRADITION CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARIAH HELEN LEE (OWNER)
(918) 806-6461
Entity
Organization

Contact information

Practice address
2021 S ELM PL, BROKEN ARROW, OK 74012-7031
(918) 806-6461
(918) 806-6710
Mailing address
2021 S ELM PL, BROKEN ARROW, OK 74012-7031
(918) 806-6461
(918) 806-6710

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200070350A
OK
Enumeration date
07/07/2006
Last updated
11/16/2010
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