OrganizationActive
Medical Muscle, LLC
NPI 1023854288 · In Home Supportive Care Agency · Broken Arrow, OK
Provider details
- NPI number
- 1023854288
- Entity type
- Organization
- Primary specialty
- In Home Supportive Care AgencyAgencies
- Organization subpart
- No
- Authorized official
- Daven Sullivan, Administrator(919) 625-6512
Specialties & taxonomies
Agencies
- Chore Provider372500000X
Nursing Service Related Providers
- Home Health Aide374U00000X
Nursing Service Related Providers
- Homemaker376J00000X
Nursing Service Related Providers
Practice location
109 S 9th St Apt 210
Broken Arrow, OK 74012-4228
Phone: (919) 625-6512
Approximate (ZIP-level) locationGet directions
Mailing address
109 S 9th St Apt 210
Broken Arrow, OK 74012-4228
Registry dates
- Enumerated
- 2024-07-06
- Last updated
- 2024-07-06
- Certified
- 2024-07-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.