Organization
PONCA CITY ORTHOPAEDIC AND SPORTS MEDICINE CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LORI L BORING RT (OFFICE MANAGER)
(580) 765-8240
Entity
Organization
Contact information
Practice address
119 PATTON DR, PONCA CITY, OK 74601-2030
(580) 765-8240
Mailing address
119 PATTON DR, PONCA CITY, OK 74601-2030
(580) 765-8240
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11690
OK
Other
Enumeration date
04/20/2007
Last updated
08/22/2020
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