Individual provider · NPI-1

Ricky Bates

Technician, Other · Oklahoma City, OK

NPI number1316481583
StatusActive
Last updated in NPPESDec 7, 2016

Details

NPI
1316481583
Entity type
Individual (NPI-1)
Name
Ricky Bates
Sex
Male
Sole proprietor
No
Enumeration date
Dec 7, 2016
Last updated
Dec 7, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247200000X Technician, Other––Yes

Practice location

1311 N Lottie Ave
Oklahoma City, OK 73117-2051

Phone 405-600-3074 · Fax 405-605-8120

Mailing address

1311 N Lottie Ave
Oklahoma City, OK 73117-2051

Phone 405-600-3074 · Fax 405-605-8120

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Other Technician, Other providers in Oklahoma City, OK