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General NPI Number Information
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NPI Number | 1861976763
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Entity Type | Organization
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Legal Business Name | NATIONS LABORATORY SERVICES, LLC
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Dates
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Enumeration Date | 09/18/2018
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Last Update Date | 09/18/2018
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Provider Practice Location Address
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Address Line | 204 E WALNUT ST
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City | TECUMSEH
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State | OK
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Zip | 74873-2030
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Country | US
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Telephone | 405-287-3028
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Fax | 405-287-3211
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Provider Business Mailing Address
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Address Line | 204 E WALNUT ST
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City | TECUMSEH
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State | OK
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Zip | 74873-2030
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Country | US
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Telephone | 405-287-3028
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Fax | 405-287-3211
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. STEVEN DEAN WEDDLE
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Credential |
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Telephone | 405-287-3028
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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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