Organization
PERRY WELLNESS CENTER PLLC
Active
Other names
Perry Wellnes Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONTHAN RADKOFF EK MD (OWNERPHYSICIAN)
(580) 336-3735
Entity
Organization
Contact information
Practice address
501 N 14TH ST, ATTN: J. EK, PERRY, OK 73077-5021
(580) 336-3735
(580) 336-3738
Mailing address
501 N 14TH ST, ATTN: J. EK, PERRY, OK 73077-5021
(580) 336-3735
(580) 336-3738
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23862
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32819
BNDD
OK
Enumeration date
09/25/2006
Last updated
03/03/2008
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