Healthcare Provider Details
I. General information
NPI: 1073303723
Provider Name (Legal Business Name): THE PERFECT POCKET
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2025
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5232 E 69TH PL
TULSA OK
74136-3407
US
IV. Provider business mailing address
5232 E 69TH PL
TULSA OK
74136-3407
US
V. Phone/Fax
- Phone: 918-727-2289
- Fax: 918-221-7814
- Phone: 918-727-2289
- Fax: 918-221-7814
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 224900000X |
| Taxonomy | Mastectomy Fitter |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KRISTIN
PURDY
Title or Position: OWNER
Credential:
Phone: 918-727-2289