Organization
TRIAD PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE MCCORKLE (CEO)
(918) 232-3064
Entity
Organization
Contact information
Practice address
6846 S CANTON AVE STE 120, TULSA, OK 74136-3412
(918) 232-3064
Mailing address
1209 S CYPRESS PL, BROKEN ARROW, OK 74012-6094
(918) 232-3064
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/24/2021
Last updated
11/24/2021
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