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General NPI Number Information
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NPI Number | 1417270760
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Entity Type | Organization
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Legal Business Name | PSS,LLC
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Dates
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Enumeration Date | 03/01/2010
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Last Update Date | 03/01/2010
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Provider Practice Location Address
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Address Line | 7225 S 85TH EAST AVE STE 200
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City | TULSA
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State | OK
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Zip | 74133-3135
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Country | US
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Telephone | 918-740-8602
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Fax | 918-461-0682
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Provider Business Mailing Address
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Address Line | 7225 S 85TH EAST AVE STE 200
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City | TULSA
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State | OK
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Zip | 74133-3135
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Country | US
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Telephone | 918-740-8602
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Fax | 918-461-0682
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Authorized Official
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Title or Position | OWNER
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Name | JOHNNY DRAKE
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Credential |
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Telephone | 918-740-8602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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