Organization
SENIORVISION OF OKLAHOMA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY KOLKER (VICE PRESIDENT)
(918) 298-4969
Entity
Organization
Contact information
Practice address
10107 S GARNETT RD, BROKEN ARROW, OK 74011-1118
(918) 252-0590
(918) 252-0591
Mailing address
11063D S MEMORIAL DR # 515, TULSA, OK 74133-7362
(918) 298-4969
(918) 298-4594
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100765700A
—
OK
Enumeration date
10/16/2018
Last updated
06/11/2019
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