Organization
LEE BOTTEM DO PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AISHA D HAIR MBA, OMT (PRACTICE MANAGER)
(918) 994-4104
Entity
Organization
Contact information
Practice address
3131 MILITARY BLVD, MUSKOGEE, OK 74401-2290
(918) 994-4104
(918) 994-4106
Mailing address
3920 E 91ST ST, TULSA, OK 74137-3602
(918) 994-4104
(918) 994-4106
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4175
OK
Other
Enumeration date
09/09/2015
Last updated
09/09/2015
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