Organization
PRIMARY CARE AT HOME LLC
Active
Organization
PRIMARY CARE AT HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MONTGOMERY MSN, RN (PRACTICE MANAGER)
(918) 346-3094
Entity
Organization
Contact information
Practice address
9526 S 86TH EAST AVE, TULSA, OK 74133-6415
(918) 346-3094
Mailing address
9526 S 86TH EAST AVE, TULSA, OK 74133-6415
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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