Organization
AMY POLGE
Active
Other names
OU Psychiatry Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ONDRIA GLEASON MD (DIRECTOR)
(918) 660-3511
Entity
Organization
Contact information
Practice address
15007 E 88TH ST N, OWASSO, OK 74055-4863
(918) 638-0302
Mailing address
15007 E 88TH ST. N, OWASSO, OK 74055
(918) 638-0302
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2653
OK
Other
Enumeration date
11/10/2011
Last updated
11/28/2011
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