Organization
OSTEOPATHIC MEDICINE OF TULSA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LEE ELLIS JR. D.O. (PHYSICIAN)
(918) 694-0684
Entity
Organization
Contact information
Practice address
6465 S YALE AVE, STE 804, TULSA, OK 74136-7823
(918) 694-0684
Mailing address
6465 S YALE AVE, STE 804, TULSA, OK 74136-7823
(918) 694-0684
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
3803
OK
Other
Enumeration date
03/16/2009
Last updated
05/26/2009
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