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General NPI Number Information
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NPI Number | 1619176179
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Entity Type | Organization
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Legal Business Name | DENIS SAVENKO
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Dates
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Enumeration Date | 07/15/2007
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Last Update Date | 07/15/2007
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Provider Practice Location Address
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Address Line | 3101 N HEMLOCK CIR SUITE 100
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City | BROKEN ARROW
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State | OK
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Zip | 74012-1103
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Country | US
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Telephone | 918-815-2402
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Fax |
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Provider Business Mailing Address
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Address Line | 5632 VAN NUYS BLVD SUITE 333
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City | VAN NUYS
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State | CA
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Zip | 91401-4602
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DENIS SAVENKO
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Credential |
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Telephone | 918-815-2402
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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 |
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License Number State |
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