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General NPI Number Information
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NPI Number | 1447585302
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Entity Type | Organization
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Legal Business Name | ARDMORE PET ASSOCIATES
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Dates
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Enumeration Date | 10/11/2009
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Last Update Date | 10/11/2009
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Provider Practice Location Address
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Address Line | 908 N ROCKFORD RD SUITE C
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City | ARDMORE
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State | OK
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Zip | 73401-2540
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Country | US
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Telephone | 580-223-7226
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Fax | 580-223-7228
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Provider Business Mailing Address
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Address Line | 720 N COMMERCE ST PMB 655
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City | ARDMORE
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State | OK
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Zip | 73401-3915
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Country | US
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Telephone | 580-223-7226
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Fax | 580-223-7228
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. STACY JO ROBERTS
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Credential |
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Telephone | 580-221-0894
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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