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General NPI Number Information
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NPI Number | 1780368399
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Entity Type | Organization
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Legal Business Name | STRIDE PODIATRIC HEALTH, LLC
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 4220 N CLASSEN BLVD STE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-2434
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Country | US
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Telephone | 405-768-5749
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Fax |
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Provider Business Mailing Address
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Address Line | 4220 N CLASSEN BLVD STE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-2434
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Country | US
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Telephone | 405-768-5749
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MICHELLE CLARK
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Credential |
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Telephone | 405-768-5749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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