PROVIDENCE SURGICAL GROUP AT BAILEY PLLC

OWASSO, OK
NPI1376692095
Entity TypeOrganization
Authorized ContactMICHAEL D MANN
Owner
918-298-2138
Organization Subpart ?No
Primary Taxonomy208600000X Surgery
(Licence: OK  24688)
Enumeration Date2007-01-10
Last Update Date2020-08-22
Business Address
PROVIDENCE SURGICAL GROUP AT BAILEY PLLC
10512 N 110TH EAST AVE SUITE 200
OWASSO, OK 74055
Phone number: 918-344-6266
Mailing Address
PROVIDENCE SURGICAL GROUP AT BAILEY PLLC
117 E 122ND PL
JENKS, OK 74037-2860
Phone number: 918-298-2138
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