Organization
MEDIC-AIRE OF TAHLEQUAH, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON T. HISELEY (PRESIDENT AND CEO)
(918) 453-9991
Entity
Organization
Contact information
Practice address
17900 MUSKOGEE AVENUE, TAHLEQUAH, OK 74464-5494
(918) 453-9991
Mailing address
17900 S MUSKOGEE AVE, TAHLEQUAH, OK 74464-5494
(918) 453-9991
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
N/A
OK
Other
Enumeration date
10/06/2006
Last updated
04/01/2008
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