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General NPI Number Information
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NPI Number | 1275960429
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Entity Type | Organization
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Legal Business Name | MAMA KNOWS, INC.
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Dates
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Enumeration Date | 10/02/2013
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Last Update Date | 10/02/2013
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Provider Practice Location Address
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Address Line | 10 W MAIN ST SUITE 420
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City | ARDMORE
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State | OK
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Zip | 73401-6516
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Country | US
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Telephone | 580-226-4238
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Fax |
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Provider Business Mailing Address
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Address Line | 10 WEST MAIN SUITE 420
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City | ARDMORE
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State | OK
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Zip | 73401
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Country | US
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Telephone | 580-226-4238
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KAYLA WALKER
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Credential |
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Telephone | 580-226-4238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 37D2050031
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License Number State | OK
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