Organization · Type 2 NPI
Looks By Malissa
General Practice Physician · Broken Arrow, OK
NPI number
1073876280
Active
Practice location
500 S Elm Pl
Broken Arrow, OK 74012-5375
Fax (918) 893-6342
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | 1880 (OK) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Another provider at this address
About NPI 1073876280
Looks By Malissa's National Provider Identifier is 1073876280, issued on Jun 21, 2012. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Broken Arrow, OK. The record was last updated on Jun 21, 2012.