Organization
NORTHEASTERN OKLAHOMA ADVANCED NEUROTHERAPEUTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER A LAJARA-NANSON MD (SOLE MEMBER)
(918) 338-3781
Entity
Organization
Contact information
Practice address
3450 E FRANK PHILLIPS BLVD, SUITE 100, BARTLESVILLE, OK 74006-2406
(918) 338-3781
(918) 338-3782
Mailing address
3450 E FRANK PHILLIPS BLVD, SUITE 100, BARTLESVILLE, OK 74006-2406
(918) 338-3781
(918) 338-3782
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
25610
OK
Other
Enumeration date
01/29/2010
Last updated
01/29/2010
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