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Organization

HEALTHY LIFE PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ROBERTA RAU M.D. (PRESIDENT/OWNER)
(918) 344-9368
Entity
Organization

Contact information

Practice address
800 W BOISE CIR, SUITE 290, BROKEN ARROW, OK 74012-4906
(918) 344-9368
Mailing address
800 W BOISE CIR, SUITE 290, BROKEN ARROW, OK 74012-4906
(918) 344-9368

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21264
OK

Other

Enumeration date
11/19/2012
Last updated
11/19/2012
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