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General NPI Number Information
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NPI Number | 1982194908
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Entity Type | Organization
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Legal Business Name | GLENPOOL PAIN MANAGEMENT LLC
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Dates
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Enumeration Date | 05/15/2018
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 148 W MAIN ST STE A
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City | GLENPOOL
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State | OK
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Zip | 74033
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Country | US
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Telephone | 918-321-2719
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Fax |
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Provider Business Mailing Address
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Address Line | 148 W MAIN ST STE A
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City | GLENPOOL
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State | OK
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Zip | 74033-3952
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Country | US
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Telephone | 918-321-2719
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER / OWNER
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Name | DR. ARRICK D. KLUGH
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Credential | D.C.
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Telephone | 918-321-2719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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