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1023548948
DIVINE PROSPERITY LLC
MUSTANG, OK
NPI
1023548948
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Entity Type
Organization
Authorized Contact
KISHORE KUMAR
Owner
855-541-2862
Organization Subpart ?
No
Primary Taxonomy
208M00000X Hospitalist
(Licence: OK 25877)
Enumeration Date
2017-06-13
Last Update Date
2017-06-13
Business Address
DIVINE PROSPERITY LLC
1104 E STATE HIGHWAY 152 UNIT 1
MUSTANG, OK 73064-5116
Phone number: 405-563-3998
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Mailing Address
DIVINE PROSPERITY LLC
15317 GRAYSON DR
EDMOND, OK 73013-2601
Phone number: 855-541-2862
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