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1669080891
PRAIRIE GARDENS MEDICAL LLC
OKLAHOMA CITY, OK
NPI
1669080891
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Entity Type
Organization
Authorized Contact
DIANNE G TUPPER
Managing Partner
405-742-8898
Organization Subpart ?
No
Primary Taxonomy
208D00000X General Practice
Enumeration Date
2020-07-14
Last Update Date
2020-09-16
Business Address
PRAIRIE GARDENS MEDICAL LLC
1213 NW 122ND ST STE 401
OKLAHOMA CITY, OK 73114-7000
Phone number: 405-962-8123
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Mailing Address
PRAIRIE GARDENS MEDICAL LLC
175 LARY LN
GUTHRIE, OK 73044-6542
Phone number: 405-962-8123
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