Organization
MIND REJUVENATION, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEGGY SUE SHEARL (OFFICE MANAGER)
(918) 340-6460
Entity
Organization
Contact information
Practice address
4922 E 73RD ST, TULSA, OK 74136-7007
(918) 392-4550
(918) 392-4551
Mailing address
4922 E 73RD ST, TULSA, OK 74136-7007
(918) 340-6460
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
01/22/2020
Last updated
03/03/2026
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