Organization
LASE MED, INC.
Active
Organization
LASE MED, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONELLA CARPENTER PHD (CEO)
(702) 953-0267
Entity
Organization
Contact information
Practice address
500 N POPLAR AVE, STE A, BROKEN ARROW, OK 74012-2337
(918) 398-9577
(918) 398-4488
Mailing address
1894 US HIGHWAY 50 E, STE 4 #160, CARSON CITY, NV 89701-3244
(702) 953-0267
(702) 967-0211
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
3803
OK
Other
Enumeration date
07/17/2007
Last updated
12/02/2009
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