Organization
NR SHAWNEE, LLC
Active
Organization
NR SHAWNEE, LLC
Active
Other names
NERVE RENEWAL SHAWNEE
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY COIT BALES (CEO)
(405) 953-7221
Entity
Organization
Contact information
Practice address
3700 N KICKAPOO AVE STE 116, SHAWNEE, OK 74804-0007
(405) 551-8103
(405) 669-3517
Mailing address
3705 NW 63RD ST STE 200, OKLAHOMA CITY, OK 73116-1937
(405) 953-7221
(405) 669-3517
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
02/01/2024
Last updated
03/03/2025
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