Organization

Pain Institute Of Tulsa, Inc

Specialist in Tulsa, OK(View on Map)

Legal Business Name

Pain Institute Of Tulsa, Inc

NPI Number

1124139126

NPI Type

Organization

Enumeration Date

08/31/2006

Specialties

(Taxonomies)

Code

174400000X

Primary Taxonomy

Yes

Licenses

State

Oklahoma
Oklahoma

License Number

1732
1434

Contact
Information

Purpose

Mailing
Location

Address

1145 S UTICA AVE
1145 S UTICA AVE

City

Tulsa
Tulsa

State

OK
OK

Postal Code

74104-4004
74104-4004

Country

US
US

Telephone Number

(918) 496-5195
(918) 496-5195

Authorized Official

Name

Raymond Sorensen

Title or Position

OWNER

Telephone Number

(918) 496-5195

Identifiers

Identifier

200088040A

Identifier State

OK

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/25/2009

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