Organization
PREVENTATIVE MEDICAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GLENN (DIRECTOR OF OPERATIONS)
(918) 739-4767
Entity
Organization
Contact information
Practice address
1305 N HIGHWAY 66, SUITE B, CATOOSA, OK 74015-2460
(918) 955-0224
Mailing address
1305 N HIGHWAY 66, SUITE B, CATOOSA, OK 74015-2460
(918) 955-0224
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
03/17/2010
Last updated
01/26/2011
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