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Organization

YOUR BEST LIFE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. FRED CARTER GLIDEWELL (OWNER)
(918) 893-1440
Entity
Organization

Contact information

Practice address
8010 S 101ST EAST AVE, SUITE 200, TULSA, OK 74133-4562
(918) 893-1440
(918) 893-1481
Mailing address
8010 S 101ST EAST AVE, SUITE 200, TULSA, OK 74133-4562
(918) 893-1440
(918) 893-1481

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28027
OK
261QM2500X
Medical Specialty Clinic/Center
28027
OK

Other

Enumeration date
11/15/2014
Last updated
11/14/2015
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