Organization
EARCARE OF PONCA CITY OUTREACH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIM BRECHEISEN (OWNER)
(316) 269-4327
Entity
Organization
Contact information
Practice address
2010 N 14TH ST, PONCA CITY, OK 74601-1917
(580) 718-9991
Mailing address
2010 N 14TH ST, PONCA CITY, OK 74601-1917
(580) 718-9991
Taxonomy
Speciality
Code
Description
License number
State
332S00000X
Hearing Aid Equipment
Primary
CE569
KS
Other
Enumeration date
06/30/2008
Last updated
07/09/2008
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