Organization
FIRST MED CLINIC S 104TH LLC
Active
Parent organization
ADVANCE PHYSICIANS GROUP, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCE PHYSICIANS GROUP, LLC
Authorized official
MR. TODD LECHTENBERGER (CEO)
(405) 471-6400
Entity
Organization
Contact information
Practice address
1140 SW 104TH ST, OKLAHOMA CITY, OK 73139-2992
(405) 691-3100
(405) 691-3106
Mailing address
1221 N KELLY AVE, EDMOND, OK 73003-4865
(405) 471-6400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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