NPI 1457481426
Indian Territory Long Term Care, INC.
Practice location
- Address
- 105 N Neshoba St, Tishomingo, OK 73460-1739
- Phone
- (580) 371-0015
- Fax
- (580) 371-3204
Authorised official
- Name
- Jayson Earl Northcutt
- Title
- Chief Operations Officer
- Phone
- (580) 371-2106
Registered specialties
Public Health or Welfare Agency
Primary
Registry record
- NPI
- 1457481426
- Entity type
- Organization
- NPI issued
- 7 Mar 2007
- Record last updated
- 20 Nov 2008
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.