Organization
INTEGRIS AMBULATORY CARE CORP
Active
Other names
INTEGRIS Jim Thorpe Rehabilitation YMCA Healthy Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
BRENT DAVIS (VICE PRESIDENT)
(405) 949-3774
Entity
Organization
Contact information
Practice address
5520 N INDEPENDENCE AVE, OKLAHOMA CITY, OK 73112-5641
(405) 945-4500
(405) 945-4501
Mailing address
5520 N INDEPENDENCE AVE, OKLAHOMA CITY, OK 73112-5641
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
01/16/2019
Last updated
01/23/2019
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