Dr. Lively'S Child & Family Wellness Ctr. PC

Organization Active NPI Exclusive Provider Organization · Cushing, OK

NPI 1710134580 · NPPES record last updated Aug 25, 2008

Key facts

NPI
1710134580
Entity type
Organization (NPI type 2)
Primary specialty
Exclusive Provider Organization 302F00000X
License
766 (OK)
Legal business name
DR. LIVELY'S CHILD & FAMILY WELLNESS CTR. PC
Practice address
5505 Ew 75TH Rd
Cushing, OK 74023-5555
Phone
(918) 225-3137
Fax
(918) 355-0298
NPI assigned
Aug 25, 2008
Organization subpart
Yes
Parent organization (as reported)
DR. K.FOR KIDS, PC

Authorized official

Name
Dr. Kathy Lynn Lively, PHD
Title
Director
Phone
(918) 225-3137

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 766 OK Yes

Addresses

Primary practice location

5505 Ew 75TH Rd
Cushing, OK 74023-5555

Mailing address

PO Box 990
Cushing, OK 74023-0990
Phone (918) 225-3137

Other names

  • Dr. K. FOR KIDS, PC Doing business as

Other providers in Cushing, OK

All providers in Cushing, OK · Exclusive Provider Organization in Oklahoma

Sources for this page

Verify at the official NPI Registry.