Organization
OSTEOPATHIC MEDICINE OF TULSA, INC.
Active
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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