Individual
RICHARD C. BOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LLP
Contact information
Practice address
3601 N MAY AVE, SUITE C, OKLAHOMA CITY, OK 73112-6641
(405) 604-5613
(405) 601-3750
Mailing address
PO BOX 12815, OKLAHOMA CITY, OK 73157-2815
(405) 604-5613
(405) 601-3750
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
57
OK
Other
Enumeration date
04/25/2011
Last updated
04/25/2011
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