Organization
MEDICAL FOOT TENDERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA CORDOVA (PRESIDENT)
(405) 625-4187
Entity
Organization
Contact information
Practice address
12021 HAWTHORNE LN, OKLAHOMA CITY, OK 73162-1944
(405) 625-4187
Mailing address
12021 N HAWTHORN LANE, OKC, OK 73162-1944
(405) 625-4187
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0063105
OK
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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