OrganizationActive
Dr. Lively'S Child & Family Wellness Ctr. PC
NPI 1710134580 · Exclusive Provider Organization · Cushing, OK
Provider details
- NPI number
- 1710134580
- Entity type
- Organization
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Parent organization
- Dr. K.for Kids, PC
- Authorized official
- Kathy Lively, Director
- License
- 766 (OK)
Practice location
5505 Ew 75th Rd
Cushing, OK 74023-5555
Phone: (918) 225-3137
Fax: (918) 355-0298
Mailing address
Po Box 990
Cushing, OK 74023-0990
Registry dates
- Enumerated
- 2008-08-25
- Last updated
- 2008-08-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.