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General NPI Number Information
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NPI Number | 1508037474
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Entity Type | Organization
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Legal Business Name | QUALLS & ASSOCIATES, INC.
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 501 N MAIN ST STE 42
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City | MUSKOGEE
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State | OK
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Zip | 74401-6329
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Country | US
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Telephone | 918-775-9900
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Fax |
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Provider Business Mailing Address
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Address Line | 201 REDBUD DR
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City | GORE
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State | OK
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Zip | 74435-5621
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Country | US
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Telephone | 918-775-9900
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Fax |
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Authorized Official
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Title or Position | CORPORATE SECRETARY/TREASURER
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Name | MRS. JOANNA M QUALLS
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Credential |
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Telephone | 918-775-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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