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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