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Organization

INDEPENDENCE TECHNOLOGIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEVIN WAYNE PENTECOST (MANAGING MEMBER)
(918) 282-6111
Entity
Organization

Contact information

Practice address
1725 W RENO ST, BROKEN ARROW, OK 74012-1460
(918) 249-5065
(918) 249-5075
Mailing address
2608 W KENOSHA ST, SUITE 622, BROKEN ARROW, OK 74012-8952
(918) 249-5065
(918) 249-5075

Taxonomy

Speciality
Code
Description
License number
State
333300000X
Emergency Response System Companies
Primary

Other

Enumeration date
12/31/2007
Last updated
12/31/2007
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