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General NPI Number Information
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NPI Number | 1841334042
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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 | 02/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2053 MAHANEY AVE
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City | TAHLEQUAH
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State | OK
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Zip | 74464-5731
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Country | US
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Telephone | 918-453-0002
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Fax | 918-453-0020
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Provider Business Mailing Address
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Address Line | 2053 MAHANEY AVE
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City | TAHLEQUAH
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State | OK
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Zip | 74464-5731
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Country | US
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Telephone | 918-453-0002
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Fax | 918-453-0020
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Authorized Official
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Title or Position | SECRETARY TREASURER
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Name | JOANNA 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 | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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