Individual
CHABLI GLAZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8905 NE 51ST ST, SPENCER, OK 73084-1420
(405) 408-9989
Mailing address
8905 NE 51ST ST, SPENCER, OK 73084-1420
(405) 408-9989
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
OK
Other
Enumeration date
11/06/2012
Last updated
01/19/2013
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