Organization
SITESOURCE MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARIE BAILEY LCSW (OWNER)
(405) 748-0122
Entity
Organization
Contact information
Practice address
324 N ROBINSON AVE, OKLAHOMA CITY, OK 73102-6416
(405) 748-0122
Mailing address
PO BOX 18622, OKLAHOMA CITY, OK 73154-0622
(405) 748-0122
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
02/20/2015
Last updated
04/01/2015
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