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General NPI Number Information
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NPI Number | 1356609739
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Entity Type | Organization
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Legal Business Name | NTCO LLC
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 12/03/2012
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Provider Practice Location Address
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Address Line | 2511 E 21ST ST
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City | TULSA
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State | OK
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Zip | 74114-1705
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Country | US
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Telephone | 918-904-8975
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Fax | 918-517-3071
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Provider Business Mailing Address
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Address Line | PO BOX 790129 DEPT 30738
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City | SAINT LOUIS
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State | MO
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Zip | 63179-0129
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Country | US
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Telephone | 918-904-8975
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Fax | 918-517-3071
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Authorized Official
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Title or Position | OWNER
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Name | MR. KEVIN J MEURET
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Credential |
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Telephone | 636-600-1137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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