Individual
BEHROOZ MAHMOODJANLOO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1713 W 33RD ST, EDMOND, OK 73013-3839
(405) 826-9255
Mailing address
1713 W 33RD ST, EDMOND, OK 73013-3839
(405) 826-9255
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
743689122
—
OK
Enumeration date
12/27/2018
Last updated
12/27/2018
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