NPI 1376406850

Blueprint Signature Services LLC

Organisation Physiological Laboratory Broken Arrow, OK

Practice location

Address: 112 W Delmar St., Broken Arrow, OK 74012
Phone: (855) 395-0763
Fax: (918) 895-0969
Mailing address: 3171 S 129th East Ave STE A-2082, Tulsa, OK 74134-3205

Authorised official

Name: Shakeia Lashae Gill
Title: Owner
Phone: (918) 841-2359

Registered specialties

Physiological Laboratory Primary

Laboratories Taxonomy 293D00000X

Other Physiological Laboratory providers in Oklahoma →

Registry record

NPI: 1376406850
Entity type: Organization
NPI issued: 3 Dec 2025
Record last updated: 3 Dec 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.