Organization
GOODWILL INDUSTRIES OF TULSA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID E OLIVER (PRESIDENT)
(918) 584-7291
Entity
Organization
Contact information
Practice address
2800 SOUTHWEST BLVD, TULSA, OK 74107-3817
(918) 584-7291
Mailing address
PO BOX 9811, TULSA, OK 74157-0811
(918) 584-7291
(918) 583-9010
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100802990G
OKLAHOMA PROVIDER ID
OK
Enumeration date
11/28/2006
Last updated
05/23/2008
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