Ok4 Ft. Gibson Opco LLC
NPI #1215382734 in Fort Gibson, Oklahoma
Provider Information
- NPI Number
- 1215382734
- Entity Type
- Organization
- Organization Name
- Ok4 Ft. Gibson Opco LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- May 3, 2016
- Last Updated
- Oct 29, 2024
Practice Location
- Address
- 205 E POPLAR ST
- City
- Fort Gibson
- State
- Oklahoma
- ZIP Code
- 74434-8272
- Phone
- (918) 478-2456
Authorized Official
- Name
- ISAAC DOLE
- Title
- MANAGER/PRINCIPAL
- Phone
- (773) 645-9246
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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