Organization Name: | LIMB SALVAGE INTERNATIONAL, INC |
NPI Number: | 1154657948 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JULIET C BURK (COO) |
Mailing Address: | 2210 N 14th St Ponca City |
State: | OK US |
Postal Code: | 74604 |
Phone Number: | 5807180002 |
Fax Number: | 5807180003 |
NPI Enumeration Date: | 10/29/2009 |
NPI Last Update Date: | 10/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 23029 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |