Miraworx of Okc 1 LLC
NPI #1053641803 in Oklahoma City, Oklahoma
Provider Information
- NPI Number
- 1053641803
- Entity Type
- Organization
- Organization Name
- Miraworx of Okc 1 LLC
- Primary Specialty
- Family Medicine - Addiction Medicine
- Enumeration Date
- Dec 29, 2009
- Last Updated
- Dec 29, 2009
Practice Location
- Address
- 10400 VINEYARD BLVD APT A
- City
- Oklahoma City
- State
- Oklahoma
- ZIP Code
- 73120-3830
- Phone
- (405) 230-1102
Authorized Official
- Name
- MRS. CAROLYN CUMMINS DAVIES, CPA
- Title
- CONSULTANT
- Phone
- (918) 286-7347
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine - Addiction Medicine — Addiction Medicine |
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