| Peoria Medical Llc | |
|
3345 S Harvard Ave, Ste #101, Tulsa, OK 74135-1812 | |
| (918) 743-3737 | |
| (918) 743-8383 |
| Full Name | Peoria Medical Llc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor - Rehabilitation |
| Location | 3345 S Harvard Ave, Tulsa, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396930277 | NPI | - | NPPES |
| 1992897920 | Other | OK | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NR0400X | Chiropractor - Rehabilitation | 3542 (Oklahoma) | Primary |
| Provider Name | Sean O Riley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1992897920 PECOS PAC ID: 7012931298 Enrollment ID: I20120326000119 |
| Provider Name | Joshan George |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1730650565 PECOS PAC ID: 1052659752 Enrollment ID: I20220915000950 |
| Provider Name | Etienne M Henriot |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1235901042 PECOS PAC ID: 2961850367 Enrollment ID: I20231125000225 |
| Mailing Address | Practice Location Address |
|---|---|
| Peoria Medical Llc 3345 S Harvard Ave, Ste #101, Tulsa, OK 74135-1812 Ph: (918) 743-3737 | Peoria Medical Llc 3345 S Harvard Ave, Ste #101, Tulsa, OK 74135-1812 Ph: (918) 743-3737 |
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Dr. Kim W Hester, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 6922 S Lewis, Tulsa, OK 74136 Phone: 918-551-6567 Fax: 918-508-7403 | |
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