| Organization Name: | LOOKS BY MALISSA |
| NPI Number: | 1073876280 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES ROY CAMPBELL (MEDICAL DIRECTOR/PRESIDENT) |
| Mailing Address: | 500 S Elm Pl Broken Arrow |
| State: | OK US |
| Postal Code: | 740125375 |
| Phone Number: | 9188729999 |
| Fax Number: | 9188936342 |
| NPI Enumeration Date: | 06/21/2012 |
| NPI Last Update Date: | 06/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 1880 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |