Organization
SOUTH TULSA OPTICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL TRAINER A.B.O.C. (GENERAL MANAGER)
(918) 494-0351
Entity
Organization
Contact information
Practice address
7171 S YALE AVE, TULSA, OK 74136-6374
(918) 494-0351
Mailing address
7171 S YALE AVE, TULSA, OK 74136-6374
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
112361
EYEMED
OK
Enumeration date
09/25/2006
Last updated
06/21/2018
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