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General NPI Number Information
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NPI Number | 1255245510
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Entity Type | Organization
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Legal Business Name | TWELVESTONE INFUSION CENTERS LLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 224 S GATEWAY PL # 101A
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City | JENKS
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State | OK
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Zip | 74037-3448
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Country | US
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Telephone | 844-893-0012
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12369
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City | MURFREESBORO
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State | TN
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Zip | 37129-0048
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | TARA HARRELSON
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Credential |
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Telephone | 615-278-3278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State | NULL
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